The effect of plant-based diets on thrombotic risk factors.

Plant­based diets are considered to improve cardiometabolic health and to protect against cardiovascular disease. Although they center around plant­based foods, they do not necessarily exclude all animal products and comprise of a range of intakes that vary according to the type and the proportion of animal products included. Numerous metabolic pathways have been identified through which plant­based diets can exert beneficial effects including improved body composition, lipid profile, and glucose metabolism and decreased inflammation and blood pressure. Their effects on thrombosis as a cardiovascular disease pathway are, however, less clear. Ample evidence for the effects of individual dietary components of plant­based diets on thrombotic risk factors exists, but the effect of whole diets and / or dietary patterns remains less­well explored with the existing literature reporting inconsistent and inconclusive findings. Here we aim to review the literature describing the effect of different plant­based diets (vegan, lacto­vegetarian, lacto­ovo­vegetarian, pescatarian, and flexitarian) and dietary patterns (Mediterranean, Nordic, Portfolio, and DASH) on specific thrombotic risk factors (fibrinogen, platelets, factor VII, fibrinolysis) in order to better clarify these relationships and to try to explain the apparent discrepant findings. We demonstrate that a one­size­fits-all conclusion cannot be drawn and that the potential antithrombotic effect of different plant­based diets depends on the nutrient composition, the content of active antithrombotic dietary components, the relative absence of prothrombotic dietary factors as well as the degree of total caloric restriction.