Einfluss von Ernährungsparametern auf die Hämostase

Zusammenfassung

Die Ernährung ist der wichtigste exogener Risikofaktor für die Prävention kardiovaskulärer Ereignisse und der Atherothrombose. Überernährung und Adipositas sind hierbei von Fehlernährung bzw. der protektiven Wirkung einzelner Nahrungsmittel zu differenzieren. Während Überernährung mit nachteiligen Veränderungen fast aller Parameter der Hämostase, Fibrinolyse und Thrombozytenaggregation assoziiert ist, führt Lebensstilmodifikation mit Gewichtsreduktion und geringer Zufuhr gesättigter Fette zu entsprechenden Normalisierungen. Epidemiologische und klinische Studien belegen andererseits den ausgeprägten Nutzen der mediterranen Kost auf kardiovaskuläre Ereignisse, der unabhängig von der Nahrungsenergiezufuhr und Cholesterinprofilen besteht. Sowohl für einfach ungesättigte Fettsäuren aus Olivenöl, aber vor allem für die Gruppe der Omega-3-Fettsäuren aus Fischöl und speziellen Pflanzenölen, Gemüse und Nüssen belegen zahlreiche Studien günstige Wirkungen auf die Hämostase. Zudem sind möglicherweise eine Vielzahl weiterer sekundärer Pflanzeninhaltsstoffe sowie moderater Alkohol-und Weinkonsum an der günstigen Wirkung der mediterranen Kost auf thrombotische Erkrankungen beteiligt. Synergistische Effekte dieser Nahrungsmittel auf Hämostase, Endothelfunktion und vaskuläre Inflammation können so die ausgeprägte Gesamtwirkung der mediterranen Kost induzieren.

Summary

Among all exogenic factors nutrition has a most relevant impact on the haemostatic system and related cardiovascular and thrombotic disease. Whereas obesity and high-caloric diet are associated with negative changes of mostly all parameters of haemostasis, fibrinolysis and platelet reactivity, weight reduction and lifestyle modification induce respective beneficial effects. Recent studies demonstrate large evidence for the beneficial effects of a mediterranean diet in thrombotic diseases not mediated by cholesterol or weight reduction. The principal sources of fat within this diet, olive oil and omega-3 polyunsaturated fatty acids from fatty fish, nuts, seeds, and vegetables show a variety of beneficial effects on the haemostatic system in experimental and observational studies. Furthermore, for an increasing number of substances such as plant-based polyphenols and for moderate alcohol consumption attenuation of coagulation and platelet reactivity have been demonstrated. In the clinical context, mediterranean diet may exert its beneficial effects through synergistic action on haemostasis, endothelial function and vascular inflammation.

Schlüsselwörter

Hämostase - Ernährung - mediterrane Kost

Keywords

Haemostasis - nutrition - mediterranean diet

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