Diet Including Olive Oil May Reduce Atherothrombotic Risk

Marlene Busko

April 03, 2019

HOUSTON — Young, healthy obese individuals who consumed olive oil at least once a week had platelets that were less likely to clot when exposed to platelet-activation agonists in a new study.

Ruina Zhang, a medical student at NYU School of Medicine, New York City, presented these findings in a poster at the American Heart Association (AHA) Epidemiology and Prevention | Lifestyle and Cardiometabolic Health Scientific Sessions 2019.

"Having platelets that are more predisposed to becoming activated is indicative of a greater propensity to thrombus, and the feared complications of that intravascularly being the heart attack or stroke," senior author Sean P. Heffron, MD, assistant professor, NYU School of Medicine and the NYU Center for the Prevention of Cardiovascular Disease, told | Medscape Cardiology.

A Mediterranean diet, which includes olive oil, he noted, has been linked to improved cardiovascular outcomes in multiple general populations.

In November 2018, the US food and Drug Administration allowed companies to add a label claim that "supportive but not conclusive scientific evidence" suggests that daily consumption of about 1½ tablespoons (20 g) of oils such as olive oil that contain at least 70% oleic acid may reduce the risk for coronary heart disease.

However, "to our knowledge," Zhang said in an AHA statement, "this is the first study to assess the effects of dietary composition, olive oil specifically, on platelet function in obese patients."

Among the study limitations, Heffron conceded, are that it was an observational cross-sectional study, that the frequency of intake of olive oil was self-reported, and that there was no indication of how much was consumed.

Nevertheless, he added, "I think this is nice supplemental information to the totality of information supportive of the cardiovascular and atherosclerotic/atherothrombotic benefit of a Mediterranean diet."

"Even in very severely obese patients, a healthy lifestyle, including a diet rich in olive oil, may help lower atherothrombotic risk," the researchers conclude.

Olive Oil, Platelets, and Obesity

To investigate the association between frequency of olive-oil intake and platelet activation, the group performed a subanalysis of an ongoing study of platelet activity in obese patients being evaluated for Roux-en-Y gastric bypass or sleeve gastrectomy bariatric surgery at their center.

They identified 87 men and women 18 to 55 years of age with a body mass index (BMI) of at least 40 kg/m², or of at least 35 kg/m² with at least one obesity related comorbidity, who had no known cardiovascular disease (CVD), didn't smoke, and were not taking lipid-lowering, antidiabetic, anticoagulant, or antiplatelet medications.

The patients had a mean age of 30 years, a mean BMI of 42 kg/m², and a mean blood pressure of 124/77 mm Hg.

On the basis of responses on a modified National Cancer Institute food frequency questionnaire, they were classified as consuming olive oil less than once per week (20 subjects), one to three times per week (34 subjects), or at least four times per week (33 subjects).

The patients also provided fasting blood samples for flow cytometry tests.

The researchers added stained antibodies to P-selectin, a marker of alpha granule release, and to PAC-1, activated IIb/IIIa receptor — both surface markers of activated platelets — to different aliquots of blood.

They measured PAC-1 and P-selectin expression, indicated by mean fluorescence intensity (MFI), without the presence of a platelet-activity agonist and with the addition 0.4 uM epinephrine or 0.025 U thrombin to activate platelets.

The degree of PAC-1 and P-selectin expression at baseline with no platelet-activation agonist was similar in the three groups.

However, individuals who reported consuming olive oil one to three times per week or at least four times per week had lower (graded) responses to the platelet-activation agonists than those who consumed olive oil less than once per week (< .05 for all).

There were no significant differences in platelet activity related to the frequency of consumption of red meat, eggs, butter, or margarine.

The researchers speculate that phenolic compounds in olive oil, which are also found in foods such as chocolate or blueberries, might alter platelet membrane phospholipid content, making platelets less susceptible to activation.

This ongoing study will also examine the relationship between olive oil consumption and platelet activation at 6 and 12 months after bariatric surgery.

Further work is needed to understand the potential mechanism and to see if exercise and other foods in a Mediterranean diet have an additive effect on platelet activation in obesity, the authors say.

The research was funded by the National Institutes of Health and by the NYU-HHC Clinical and Translational Science Institute. The authors have no relevant financial disclosures.

American Heart Association (AHA) Epidemiology and Prevention | Lifestyle and Cardiometabolic Health Scientific Sessions 2019: Abstract P335. Presented March 7, 2017.

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