Mediterranean Diet Maintained Platelet Count within a Healthy Range and Decreased Thrombocytopenia-Related Mortality Risk: A Randomized Controlled Trial

Hernáez, Álvaro; Lassale, Camille; Castro-Barquero, Sara; Ros, Emilio; Tresserra-Rimbau, Anna; Castañer, Olga; Pintó, Xavier; Vázquez-Ruiz, Zenaida; Sorlí, José V.; Salas-Salvadó, Jordi; Lapetra, José; Gómez-Gracia, Enrique; Alonso-Gómez, Ángel M.; Fiol, Miquel; Serra-Majem, Lluis; Sacanella, Emilio; Razquin, Cristina; Corella, Dolores; Guasch-Ferré, Marta; Cofán, Montserrat; Estruch, Ramón

doi:10.3390/nu13020559

Open AccessArticle

Mediterranean Diet Maintained Platelet Count within a Healthy Range and Decreased Thrombocytopenia-Related Mortality Risk: A Randomized Controlled Trial

by

Álvaro Hernáez

^1,2,3,4,*

,

Camille Lassale

^2,5

,

Sara Castro-Barquero

^1,2,6

,

Emilio Ros

^1,2,7,

Anna Tresserra-Rimbau

^2,8,9,10

,

Olga Castañer

^2,5

,

Xavier Pintó

^2,11

,

Zenaida Vázquez-Ruiz

^2,12

,

José V. Sorlí

^2,13

,

Jordi Salas-Salvadó

^2,9,10

,

José Lapetra

^2,14,

Enrique Gómez-Gracia

¹⁵,

Ángel M. Alonso-Gómez

^2,16

,

Miquel Fiol

^2,17,

Lluis Serra-Majem

^2,18,19,

Emilio Sacanella

^1,2,6,20

,

Cristina Razquin

^2,12,21

,

Dolores Corella

^2,13

,

Marta Guasch-Ferré

^2,10,22

,

Montserrat Cofán

^1,2,7

and

Ramón Estruch

^1,2,6,20

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¹

August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain

²

Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain

³

Blanquerna School of Health Sciences, Universitat Ramon Llull, 08025 Barcelona, Spain

⁴

Centre for Fertility and Health (CeFH), Norwegian Institute of Public Health, 0473 Oslo, Norway

⁵

Cardiovascular Risk and Nutrition Research Group, Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, Spain

⁶

Department of Medicine, Faculty of Medicine and Health Sciences, University of Barcelona, 08036 Barcelona, Spain

⁷

Lipid Clinic, Endocrinology and Nutrition Service, Hospital Clínic, 08036 Barcelona, Spain

⁸

Department of Nutrition, Food Science and Gastronomy, XaRTA, INSA, Faculty of Pharmacy and Food Sciences, University of Barcelona, 08028 Barcelona, Spain

⁹

Unitat de Nutrició Humana, Departament de Bioquimica i Biotecnologia, Universitat Rovira i Virgili, Hospital Universitari Sant Joan de Reus, 43201 Reus, Spain

¹⁰

Institut d’Investigació Pere Virgili (IISPV), 43204 Reus, Spain

¹¹

Lipids and Vascular Risk Unit, Internal Medicine Service, Hospital Universitario de Bellvitge, 08907 L’Hospitalet de Llobregat, Spain

¹²

Department of Preventive Medicine and Public Health, Universidad de Navarra, 31008 Pamplona, Spain

¹³

Department of Preventive Medicine, Universidad de Valencia, 46010 Valencia, Spain

¹⁴

Research Unit, Department of Family Medicine, Distrito Sanitario Atención Primaria Sevilla, 41013 Sevilla, Spain

¹⁵

Department of Preventive Medicine and Public Health, Universidad de Málaga, 29071 Málaga, Spain

¹⁶

Bioaraba Health Research Institute, Osakidetza Basque Health Service, Araba University Hospital, University of the Basque Country UPV/EHU, 01009 Vitoria-Gasteiz, Spain

¹⁷

Health Research Institute of the Balearic Islands (IdISBa), Hospital Son Espases, 07120 Palma de Mallorca, Spain

¹⁸

Instituto de Investigaciones Biomédicas y Sanitarias, Universidad de Las Palmas de Gran Canaria, 35016 Las Palmas, Spain

¹⁹

Centro Hospitalario Universitario Insular Materno Infantil (CHUIMI), Servicio Canario de Salud, 35016 Las Palmas, Spain

²⁰

Internal Medicine Service, Hospital Clínic, 08036 Barcelona, Spain

²¹

Department of Endocrinology and Nutrition, Complejo Hospitalario de Navarra, 31008 Pamplona, Spain

²²

Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA 02115, USA

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^*

Author to whom correspondence should be addressed.

Nutrients 2021, 13(2), 559; https://doi.org/10.3390/nu13020559

Submission received: 8 January 2021 / Revised: 3 February 2021 / Accepted: 3 February 2021 / Published: 8 February 2021

(This article belongs to the Special Issue Effect of Diet on Vascular Function and Hormones)

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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.

Keywords: Mediterranean diet; platelet count; thrombocytopenia; randomized controlled trial; prevention

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MDPI and ACS Style

Hernáez, Á.; Lassale, C.; Castro-Barquero, S.; Ros, E.; Tresserra-Rimbau, A.; Castañer, O.; Pintó, X.; Vázquez-Ruiz, Z.; Sorlí, J.V.; Salas-Salvadó, J.; et al. Mediterranean Diet Maintained Platelet Count within a Healthy Range and Decreased Thrombocytopenia-Related Mortality Risk: A Randomized Controlled Trial. Nutrients 2021, 13, 559. https://doi.org/10.3390/nu13020559

AMA Style

Hernáez Á, Lassale C, Castro-Barquero S, Ros E, Tresserra-Rimbau A, Castañer O, Pintó X, Vázquez-Ruiz Z, Sorlí JV, Salas-Salvadó J, et al. Mediterranean Diet Maintained Platelet Count within a Healthy Range and Decreased Thrombocytopenia-Related Mortality Risk: A Randomized Controlled Trial. Nutrients. 2021; 13(2):559. https://doi.org/10.3390/nu13020559

Chicago/Turabian Style

Hernáez, Álvaro, Camille Lassale, Sara Castro-Barquero, Emilio Ros, Anna Tresserra-Rimbau, Olga Castañer, Xavier Pintó, Zenaida Vázquez-Ruiz, José V. Sorlí, Jordi Salas-Salvadó, and et al. 2021. "Mediterranean Diet Maintained Platelet Count within a Healthy Range and Decreased Thrombocytopenia-Related Mortality Risk: A Randomized Controlled Trial" Nutrients 13, no. 2: 559. https://doi.org/10.3390/nu13020559

APA Style

Hernáez, Á., Lassale, C., Castro-Barquero, S., Ros, E., Tresserra-Rimbau, A., Castañer, O., Pintó, X., Vázquez-Ruiz, Z., Sorlí, J. V., Salas-Salvadó, J., Lapetra, J., Gómez-Gracia, E., Alonso-Gómez, Á. M., Fiol, M., Serra-Majem, L., Sacanella, E., Razquin, C., Corella, D., Guasch-Ferré, M., ... Estruch, R. (2021). Mediterranean Diet Maintained Platelet Count within a Healthy Range and Decreased Thrombocytopenia-Related Mortality Risk: A Randomized Controlled Trial. Nutrients, 13(2), 559. https://doi.org/10.3390/nu13020559

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Mediterranean Diet Maintained Platelet Count within a Healthy Range and Decreased Thrombocytopenia-Related Mortality Risk: A Randomized Controlled Trial

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