Food Lipids: Chemistry, Nutrition, and Biotechnology

from cardiovascular disease [73,74]. In addition, from the Northwick Park Heart
Study (NPHS) has been reported that low and, unexpectedly, also high concentrations
of antithrombin III were associated with increased deaths from CHD [75]. It must
be noted that these prospective studies have only been carried out in males; whether
associations for females are similar awaits confirmation.
3. Dietary Fats and Coagulation
a. Total Fat Content of Diets. Marckmann and colleagues [76] have investigated
both short and longer term effects of low-fat/high-fiber diets on human blood coagulation.
In an 8-month study it was found a low-fat/high-fiber diet significantly
decreased plasma factor VII coagulant activity by 5–10%, but only in the first 2
months and in the last months of dietary intervention. Absence of effects in the
middle-study period was explained by the fact that the subjects in this period did
not follow the dietary guidelines strictly due to allowed study holidays. Plasma fibrinogen
concentrations were not changed [76]. The results of this study were confirmed
in a study of shorter duration [77].
In another study, Marckmann et al. [78] investigated whether the low-fat or the
high-fiber component of diets was responsible for decreased factor VII coagulant
activity found in earlier studies. The experimental diets of this trial only differed in
their fat content (39 vs. 31% of energy) and carbohydrate content (47 vs. 54% of
energy). Factor VII coagulant activity was similar on the low-fat and high-fat diets.
In addition, no changes in fibrinogen concentrations were found. This limited number
of studies indicates reducing effects on factor VII coagulation activity of low-fat/
high-fiber diets. However, more controlled studies are needed to definitely address
whether the reduced fat content of low-fat diets, the increased fiber content, or a
combination of these two dietary factors are responsible for the decreased factor VII
coagulant activity of such diets.
b. Dietary Fatty Acid Composition. The effects of saturated compared with unsaturated
fatty acids have been studied in several experiments. Factor VII antigen,
factor VII coagulant activity, and estimated factor VIIa increased with diets high in
saturated fatty acids compared with unsaturated fatty acids [79]. This study included
only four men and one woman, and the experimental diets were extremely high
(62% of energy) in fat content. Additional experiments were designed to investigate
the effects of different ratios of polyunsaturated to saturated fatty acid content (P/S
ratio), at more realistic fat intakes of 32% of energy [80] or 40% of energy [81].
One study [80] did not indicate changes of factor VII coagulant activity on a diet
with a P/S ratio of 0.3 versus a diet with a P/S ratio of 0.9. Another study [81]
reported only slightly increased (1.7%) factor VII antigen concentrations when the
dietary P/S ratio was decreased from 3.0 to 0.3. Fibrinogen concentrations were not
measured in these studies.
Diets enriched in n-3 fatty acids from fish did not change factor VII coagulant
activity [82,83] or fibrinogen concentrations [82–84].
A study of Almendingen et al. [85] investigated the effects of trans fatty acids
in diets enriched in hydrogenated fish oil or hydrogenated soybean oil compared
with a diet enriched in butterfat. The diet enriched in butterfat showed slightly increased
fibrinogen concentrations as compared with the hydrogenated fish oil diet.
No significant differences in the levels of factor VII or fibrin degradation products
were observed.
Copyright 2002 by Marcel Dekker, Inc. All Rights Reserved.