Long-term effects on haemostatic variables of three ad libitum diets differing in type and amount of fat and carbohydrate: a 6-month randomised study in obese individuals

Diet is important in the prevention of CVD, and it has been suggested that a diet high in MUFA is more cardioprotective than a low-fat diet. We hypothesised that the thrombotic risk profile is improved most favourably by a high-MUFA diet compared with a low-fat diet. This was tested in a parallel randomised intervention trial on overweight individuals (aged 28.2 (SD 4.6) years) randomly assigned to a diet providing a moderate amount of fat (35-45% of energy; >20% of fat as MUFA) (MUFA diet; n 39), to a low-fat (LF; 20-30% of energy) diet (n 43), or to a control diet (35% of energy as fat; n 24) for 6 months after a weight loss of about 10%. Protein constituted 10-20% of energy in all three diets. All foods were provided free of charge from a purpose-built supermarket. Fasting blood samples were collected before and after intervention and analysed for factor VII coagulant activity (FVII: c), fibrinogen, prothrombin fragment 1 + 2 (F1 + 2), D-dimer and plasminogen activator inhibitor (PAI). The fibrinogen concentration was significantly lowered by the LF diet, but not by the MUFA diet. Changes in fibrinogen differed significantly between diet groups. BMI and PAI concentration increased and D-dimer concentrations were reduced irrespective of the diets. No changes were observed for FVII: c and F1 + 2. Our findings suggest that in overweight subjects after weight loss the thrombotic risk profile is improved most favourably by the LF diet compared with the MUFA diet based on the reduction in fibrinogen concentrations.