Anti-inflammatory diet may ward off venous thromboembolism among smokers

Eating foods that fight inflammation appears to factor in lowering the risk of developing venous thromboembolism (VTE), especially among people who smoke, as suggested in a study.

Specifically, individuals in who consume high vs low amounts of anti-inflammatory foods have a 9-percent (95 percent confidence interval [CI], 0–17) lower risk of VTE, according to the investigators. This association is more pronounced among current and past smokers (hazard ratio [HR], 0.80, 95 percent CI, 0.70–0.91); p_interaction=0.004). [Nutr Metab Cardiovasc Dis 2021;31:2831-2838]

“These findings may suggest that a diet with high anti-inflammatory potential partially offsets the cardiovascular risk introduced by smoking,” according to the investigators.

In the study, the investigators followed 81,507 middle-aged and older Swedish adults without a history of VTE at baseline and estimated their anti-inflammatory diet index (AIDI) scores, which indicated the anti-inflammatory potential of a diet.

AIDI was based on twelve foods with anti-inflammatory potential and five foods with pro-inflammatory potential. The inflammation-fighting foods included fruits and vegetables, tea, coffee, whole grain bread, breakfast cereals, low-fat cheese, olive oil and canola oil, chocolate, nuts, legumes, red wine, and beer. Foods that promote inflammation were unprocessed red meat, processed red meat, organ meats, French fries, and soft-drink beverages.

Individuals with lower vs higher AIDI score (score ≥8 vs ≤4) tended to be men, older, have higher body mass index, lower education levels, and lower levels of walking or cycling, and were less likely to regularly use dietary supplements. The former group was also more likely to have a history of diabetes and hypertension.

Over a mean follow-up time of 17.8 years, 5,241 individuals developed VTE (mean age at diagnosis 74.6 years), yielding an incidence rate of 3.6 per 1,000 person-years. Multivariable Cox proportional hazards regression models showed that the risk of VTE was lower by 12 percent and 8 percent among individuals in the two highest quartiles of AIDI compared with those in the lowest quartile.

Furthermore, for each 1-point increment in the AIDI score, the risk of VTE decreased by 2 percent in the overall population and by 4 percent among current and past smokers.

Looking at the individual components of AIDI, fruit and vegetable consumption protected against pulmonary embolism (per serving increase: hazard ratio [HR], 0.98, 95 percent CI, 0.96–1.00), while wine intake conferred a benefit for deep vein thrombosis (per serving increase: HR, 0.96, 95 percent CI, 0.92–1.00). On the other hand, French fries heightened the risk of VTE (HR per serving, 1.33, 95 percent CI, 1.06–1.67), especially pulmonary embolism.

“Our findings on one side implied the importance of a healthy diet, in particular a diet of high anti-inflammation potential, in development of VTE, which may facilitate the completeness of the primary prevention strategies for this disease, especially in smokers,” the investigators said.

“On the other hand, our results might strengthen the evidence that the inflammation acts as one pathological basis for thrombosis, which hints the worth of future clinical research on anti-inflammation treatments, such as aspirin, for VTE prevention,” they added. [Hematology Am Soc Hematol Educ Program 2020;634-641]