Original Communication | Published:

Complementary effects of Mediterranean diet and moderate red wine intake on haemostatic cardiovascular risk factors

European Journal of Clinical Nutritionvolume 55pages444451 (2001) | Download Citation

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Abstract

Objectives: To compare the effect of alcohol-free Mediterranean-type diet (MD) and high-fat diet (HFD) on plasma concentration of emergent haemostatic cardiovascular risk factors (HCVRF). Also, to test if red wine supplementation modifies HCVRF, independent of diet.

Design, subjects and intervention: Controlled prospective intervention study. Two groups, each of 21 healthy male university students (22±3.4 y), received either MD or HFD for 90 days. Between days 30 and 60, both diets were supplemented with 240 ml/day of red wine. Baseline and T30, T60 and T90-day samples were drawn. No drop out from the study was observed.

Setting: University campus and outpatient nutrition clinic.

Results: Volunteers on HFD at T30 had increases in pro-coagulants fibrinogen (22%), factor VIIc (9%), and factor VIIIc (4%), and decreases in natural anticoagulants antithrombin III (3%), protein C (11%) and protein S (6%) and of 20% in plasminogen activator inhibitor-1. At the same time, individuals on MD had increases in fibrinogen (4%), antithrombin III (5%), protein C (3%), protein S (2.7%), and decreases in factor VIIIc (9%), and plasminogen activator inhibitor-1 (21%). After adjusting by baseline values, MD was associated with lower plasma fibrinogen (P=0.03), factor VIIc (P=0.034) and factor VIIIc (P=0.0057) and with higher levels of protein S (P=0.013). Red wine supplementation, in both diets, resulted in decreased plasma fibrinogen (P=0.001) and factor VIIc (P=0.05), and increased tissue plasminogen activator antigen (P=0.01) and plasminogen activator inhibitor-1 antigen (P=0.0003). Wine consumption was also associated with significantly (P=0.01) divergent effects on antithrombin III: it decreased by 10% in individuals on HFD but increased slightly in those on MD. No effects of diet or wine were detected in plasma protein C and C-reactive protein.

Conclusion: MD and moderate consumption of red wine have complementary, mostly beneficial effects on HCVRF.

Sponsorship: P Catholic University of Chile.

Descriptors: diet; wine; haemostasis; cardiovascular risk factors

European Journal of Clinical Nutrition (2001) 55, 444–451

References

  1. Anderson JL, Muhlestein JB, Habashi J, Carlquist JF, Bair TL, Elmer SP & Davis BP (1999) Lack of association of a common polymorphism of the plasminogen activator inhibitor-1 gene with coronary artery disease and myocardial infarction J. Am. Coll. Cardiol 34 1778–1783

  2. Berger K, Ajani UA, Kase CS, Gazianno JM, Buring JE, Glynn RJ & Hennekens CH (1999) Light-to-moderate alcohol consumption and the risk of stroke among US male physicians New Engl. J. Med 341 l557–1564

  3. Bijnen FCH, Feskens EJM, Giampaoli S, Menotti A, Fidanza F, Hornstra G, Caspersen CJ, Mosterd WL & Kromhout D (1996) Haemostatic parameters and lifestyle factors in elderly men in Italy and The Netherlands Thromb. Haemost 76 411–416

  4. Browner WS, Westenhouse J & Tice JA (1991) What if Americans ate less fat? A quantitative estimate on the effect on mortality J.A.M.A. 265 3285–3291

  5. Callas PW, Tracy RP, Bovill EG, Cannon C, Thompson B & Mann KG (1998) The association of anticoagulant protein concentrations with acute myocardial infarction in the thrombolysis in Myocardial Infarction Phase II (TIMI II) Trial J. Thromb. Thrombol 5 53–60

  6. Christie WW (1989) The analysis of fatty acids In Gas Chromatography and Lipids. A Practical Guide, Part 2, ed. WW Christie 64–183. Scotland: Oily Press.

  7. Cuevas AM, Guash V, Castillo O, Irribarra V, Mizo´n C, San Martín A, Strobel P, Pe´rez D, Germain AM & Leighton F (2000) A high-fat diet induces and red wine counteracts endothelial dysfunction in human volunteers Lipids 35 143–148

  8. de Lorgeril M & Salen P (1999) Wine ethanol, platelets, and Mediterranean diet Lancet 353 106 7

  9. de Lorgeril M, Salen P, Martin JL, Monjaud I, Delaye J & Mamelle N (1999) Mediterranean diet, traditional risk factors, and the rate of cardiovascular complications after myocardial infarction: final report of the Lyon Diet Heart Study Circulation 99 779–785

  10. de Lorgeril M & Salen P (2000) Modified Cretan Mediterranean diet in the prevention of coronary heart disease and cancer In Mediterranean Diets ed. AP Simopoulos and F Visioli 1–23. Basel: Karger

  11. Dimmitt SB, Rakic V, Puddey IB, Baker R, Oostrick R, Adams MJ, Chesterman CN, Burke V & Beilin LJ (1998) The effects of alcohol on coagulation and fibrinolytic factors: a controlled trial Blood Coagul. Fibrinol 9 39–45

  12. Doggen CJ, Manger Cats V, Bertina RM, Reitsma PH, Vandenbroucke JP & Rosendaal FR (1998) A genetic propensity to high factor VII is not associated with the risk of myocardial infarction in men Thromb. Haemost 80 281–285

  13. Doggen CJ, Bertina RM, Manger Cats V, Reitsma PH & Rosendaal FR (1999) The 4G/5G polymorphism in the plasminogen activator inhibitor-1 gene is not associated with myocardial infarction Thromb. Haemost 82 115–120

  14. Feng D, Toffler GH, Larson MG, O'Donnell CJ, Lipinska I, Schmitz C, Sutherland PA, Johnstone MT, Muller JE, D'Agostino RB, Levy D & Lindpainter K (2000) Factor VII gene polymorphism, factor VII levels, and prevalent cardiovascular disease: the Framingham Heart Study Arterioscler. Thromb. Vasc. Biol 20 593–600

  15. Ferro-Luzzi A & Branca F (1995) Mediterranean diet, Italianstyle: prototype of a healthy diet Am. J. Clin. Nutr 61 1338S–1345S

  16. Ghaddar HM, Folsom AR, Aleksic N, Hearne LB, Chambless LE, Morrissey JH & Wu KK (1998) Correlation of factor VIIa values with factor VII gene polymorphism, fasting and postprandial triglyceride levels, and subclinical carotid atherosclerosis Circulation 98 2815–2821

  17. Gill J, Endres-Brooks J, Bauer PJ, Marks WJ Jr & Montgomery RR (1987) The effect of ABO blood group on the diagnosis of von Willebrand disease Blood 69 1691–1695

  18. Held C, Hjemdahl P, Hakan Wallen N, Bjorkander I, Forslund L, Wiman B & Rehnqvist N (2000) Inflammatory and haemostatic markers in relation to cardiovascular prognosis in patients with stable angina pectoris. Results from the APSIS study. The Angina Prognosis Study in Stockholm Atherosclerosis 148 179–188

  19. Hendriks HFJ, Veenstra J, Velthuis-te Wierik EJM, Schaafsma G & Kluft C (1994) Effect of moderate dose of alcohol with evening meal on fibrinolytic factors Br. Med. J 308 l003–1006

  20. Iacoviello L, Di Castelnuovo A, De Knijff P, D'Orazio A, Amore C, Arboretti R, Kluft C & Donati MB (1998) Polymorphisms in the coagulation factor VII gene and the risk of myocardial infarction New Engl. J. Med 338 79–85

  21. Inbal A, Freimark D, Modan B, Chetrit A, Matetzky S, Rosenberg N, Dardik R, Baron Z & Seligsohn U (1999) Synergistic effects of prothrombotic polymorphisms and atherogenic factors on the risk of myocardial infarction in young males Blood 93 186–190

  22. Ishikawa S, Kario K, Nago N, Kayaba K, Hiraoka J, Matsuo H, Goto T, Miyamoto T, Tsutsumi A, Nakamura Y, Shimada K, Inoue K & Igarashi M (1997) Factor VII and fibrinogen levels examined by age, sex, and other atherosclerotic risk factors in a Japanese population. The Jichi Medical School Cohort Study Thromb. Haemost 77 890–893

  23. Johansen KM, Skorpe S, Olsen JO & Østerud B (1999) The effect of red wine on the fibrinolytic system and the cellular activation reactions before and after exercise Thromb. Res 96 355–363

  24. Kouris-Blazos A, Gnardellis C, Wahlqvist ML, Trichopoulos D, Lukito W & Trichopoulou A (1999) Are the advantages of the Mediterranean diet transferable to other populations? A cohort study in Melbourne, Australia Br. J. Nutr 82 57–61

  25. Kromhout D (1999) Serum cholesterol in cross-cultural perspective. The Seven Countries Study Acta Cardiol 54 l55–158

  26. Larsen LF, Bladbjerg EM, Jespersen J & Marckmann P (1997) Effects of dietary fat quality and quantity on postprandial activation of blood coagulation factor VII Arterioscler. Thromb. Vasc. Biol 17 2904–2909

  27. Macy EM, Hayes TE & Tracy RP (1997) Variability in the measurement of C-reactive protein in healthy subjects: implications for reference intervals and epidemiological applications Clin. Chem 43 52–58

  28. Mead TW, Brozovic M, Chakrabarti RR, 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 533–537

  29. Mennen LI, Balkau B, Vol S, Caces E & Eschwege E (1999) Fibrinogen: a possible link between alcohol consumption and cardiovascular disease? Arterioscler. Thromb. Vasc. Biol 19 887–892

  30. Menotti A, Kromhout D, Blackburn H, Fidanza F, Buzina R & Nissinen A (1999) Food intake patterns and 25-year mortality from coronary heart disease: cross-cultural correlations in the Seven Countries Study. The Seven Countries Study Research Group Eur. J. Epidemiol 15 507–515

  31. Mezzano D, Mun˜oz X, Martínez C, Cuevas A, Panes O, Aranda E, Guasch V, Strobel P, Mun˜oz B, Rodríguez S, Pereira J & Leighton F (1999) Vegetarians and cardiovascular risk factors: haemostasis, inflammatory markers and plasma homocysteine Thromb. Haemost 81 913–917

  32. Motchnik PA, Frei B & Ames BN (1994) Measurement of antioxidants in human blood plasma Meth. Enzymol 234 269–279

  33. Pellegrini N, Pareti FI, Stabile F, Brusamolino A & Simonetti P (1996) Effect of moderate consumption of red wine on platelet aggregation and haemostatic variables in healthy volunteers Eur. J. Clin. Nutr 50 209–213

  34. Redondo M, Watzke HH, Stucki B, Sulzer I, Biasiutti FD, Binder BR, Furlan M, Lammle B & Wuillemin WA (1999) Coagulation factors II, V, VII and X, prothrombin gene 20210G-A transition, and factor V Leiden in coronary artery disease: high factor V clotting activity is an independent risk factor for myocardial infarction Arterioscler. Thromb. Vasc. Biol 19 1020–1025

  35. Renaud S & de Lorgeril M (1992) Wine, alcohol, platelets, and the French paradox for coronary heart disease Lancet 339 1523–1526

  36. Ridker PM (1997) Fibrinolytic and inflammatory markers for arterial occlusion: the evolving epidemiology of thrombosis and haemostasis Thromb. Haemost 78 53–59

  37. Ridker PM, Hennekens CH, Stampfer MJ, Manson JE & Vaughan DE (1994) Prospective study of endogenous tissue plasminogen activator and risk of stroke Lancet 343 940–943

  38. Ridker PM, Vaughan DE, Stampfer MJ, Glynn RJ & Hennekens CH (1994) Association of moderate alcohol consumption and plasma concentration of endogenous tissue-type plasminogen activator J.A.M.A. 272 929–933

  39. Ridker PM, Vaughan DE, Stampfer MJ, Manson JE & Hennekens CH (1993) Endogenous tissue-type plasminogen activator and risk of myocardial infarction Lancet 341 1165–1168

  40. Rimm EB, Williams P, Fosher K, Criqui M & Stampfer MJ (1999) Moderate alcohol intake and lower risk of coronary heart disease: meta-analysis of effects on lipids and haemostatic factors Br. Med. J 319 1523–1528

  41. Roche HM, Zampelas A, Knapper JM, 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 Am. J. Clin. Nutr 68 552–560

  42. Rosendaal FR, Siscovick DS, Schwartz SM, Beverly RK, Psaty BM, Longstreth WT Jr, Raghunathan TE, Koepsell TD & Reitsma PH (1997) Factor V Leiden (resistance to activated protein C) increases the risk of myocardial infarction in young women Blood 89 2817–2821

  43. Rosendaal FR, Siscovick DS, Schwartz SM, Psaty BM, Raghunathan TE & Vos HL (1997) A common prothrombin variant (20210 G to A) increases the risk of myocardial infarction in young women Blood 90 1747–1750

  44. Rumley A, Lowe GD, Sweetnam PM, Yarnell JW & Ford RP (1999) Factor VIII, von Willebrand factor and the risk of major ischaemic heart disease in the Caerphilly Heart Study Br. J. Haematol 105 110–116

  45. Sakata T, Kario K, Katayama Y, Matsuyama T, Kato & Miyata T (1999) Analysis of 45 episodes of arterial occlusive disease in Japanese patients with congenital protein C deficiency Thromb. Res 94 69–78

  46. Temme EH, Mensink RP & Hornstra G (1999) Effects of diets enriched in lauric, palmitic or oleic acids on blood coagulation and fibrinolysis Thromb. Haemost 81 259–263

  47. Thun MJ, Peto R, Lopez AD, Monaco JH, Henley SJ, Heath CW Jr & Doll R (1997) Alcohol consumption and mortality among middle-aged and elderly US adults New Engl. J. Med 337 1705–1714

  48. Tjonneland A, Gronbaek M, Stripp C & Overvad K (1999) Wine intake and diet in a random sample of 48,763 Danish men and women Am. J. Clin. Nutr 69 49–54

  49. Tracy RP, Arnold AM, Ettinger W, Fried L, Meilahn E & Savage P (1999) The relationship of fibrinogen and factors VII and VIII to incident cardiovascular disease and death in the elderly: results from the cardiovascular health study Arterioscler. Thromb. Vasc. Biol 19 l776–1783

  50. Verbeke G & Molenberghs G (1997) Linear Mixed Models in Practice: a SAS-oriented Approach New York: Springer

  51. Visioli F (2000) Antioxidants in Mediterranean diets In Mediterranean Diets, ed. AP Simopoulos and F Visioli 43–55. Basel: Karger

  52. Wannamethee SG & Shaper AG (1999) Type of alcoholic drink and risk of major coronary heart disease events and all-cause mortality Am. J. Public Health 89 685–690

  53. Weststrate JA, van het Hof KH, van den Berg H, Velthuis-te-Wierik EJ, de Graaf C, Zimmermanns NJ, Westerterp KR, WesterterpPlantenga MS & Verboeket-van de Venne WP (1998) A comparison of the effect of free access to reduced fat products or their full fat equivalents on food intake, body weight, blood lipids and fat-soluble antioxidants levels and haemostasis variables Eur. J. Clin. Nutr 52 389–395

  54. Zoller B, García de Frutos P & Dahlback B (1998) A common 4G allele in the promoter of the plasminogen activator inhibitor-1 (PAI-1) gene as a risk factor for pulmonary embolism and arterial thrombosis in hereditary protein S deficiency Thromb. Haemost 79 802–807

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Acknowledgements

This work was supported by grant PUC-PBMEC98 (Molecular Basis of Chronic Diseases Program, Catholic University of Chile) and grant no. 1990508 from FONDECYT (Fondo Nacional de Ciencia y Tecnología, Chile).

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Author notes

  1. D Mezzano: Guarantor: D Mezzano.

  2. D Mezzano, F Leighton, C Martínez, G Marshall, A Cuevas, O Castillo, O Panes, B Muñoz, DD Pérez, C Mizón, J Rozowski, A San Martín and J Pereira: Contributors: DM, FL, GM, AC, JR and JP participated in the conception and design of the study, in the analysis and interpretation of data and in writing the article. CM and OC participated in clinical control of participants, diet design and daily supervision of the diet. CM, OP, BM and DP provided administrative, technical and logistic support and completed the experimental work. GM and ASM were responsible for statistical analysis.

Affiliations

  1. Department of Hematology-Oncology, School of Medicine, Catholic University of Chile, Santiago, Chile

    • D Mezzano
    • , C Martínez
    • , O Panes
    • , B Muñoz
    •  & J Pereira
  2. Biochemical Cytology and Lipids Laboratory, Faculty of Biological Sciences, School of Medicine, Catholic University of Chile, Santiago, Chile

    • F Leighton
    • , DD Pérez
    •  & A San Martín
  3. Department of Public Health, School of Medicine, Catholic University of Chile, Santiago, Chile

    • G Marshall
  4. Department of Nutrition, Diabetes and Metabolism, School of Medicine, Catholic University of Chile, Santiago, Chile

    • A Cuevas
    • , O Castillo
    • , C Mizón
    •  & J Rozowski

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Correspondence to D Mezzano.

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https://doi.org/10.1038/sj.ejcn.1601202

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