The morphological and physiological effects of a low-carbohydrate high-fat diet on coagulation parameters

Abstract

The contribution of unhealthy diets to the emergence of chronic diseases which are a burden to both the society and health care costs, greatly increased over the last decades. Starch and sugar have been linked to the development of chronic diseases and therefore the World Health Organisation is endorsing efforts to cut the intake of digestible starch and sugar. A decrease in the intake of starch and sugar will potentially decrease the risk of chronic diseases like obesity, type 2 diabetes mellitus, hypercholesterolemia, hypertension, metabolic syndrome, coronary heart disease and cancer. A low-carbohydrate high-fat diet has emerged as a treatment strategy to reduce sugar and starch-linked chronic diseases. However, it has been hypothesized that the low-carbohydrate high-fat diet stimulates inflammatory pathways. In this research study, scanning electron microscopy, flow cytometry, and thromboelastography were used to compare blood parameters in participants either on a low-carbohydrate high-fat diet or on a control diet. Healthy volunteers, eating foods without specific restrictions on intake of dietary categories were recruited to form the control group (n=32) and individuals with food intake restrictions limiting carbohydrate intake while increasing fat intake were recruited to form the low-carbohydrate high-fat group (n=32). Platelet-rich plasma, with or without thrombin, was used to study platelet-fibrin network and red blood cell morphology. Distinct changes were noted in the morphology of red blood cells, platelets and fibrin networks of individuals on a low-carbohydrate high-fat diet. Fibrin network fibers for participants in the low-carbohydrate high-fat group were mostly discontinuous, with some regions with matted deposits. Activated and aggregated platelets were identified morphologically using scanning electron microscopy and platelet activity was further quantified with flow cytometry. Flow cytometric results showed lower mean platelet aggregation in low-carbohydrate high-fat diet participants compared to controls. Thromboelastography was used to compare coagulation parameters of whole blood in low-carbohydrate high-fat diet participants with those of controls. Thromboelastography results show that in low-carbohydrate high-fat diet participants, on average, clot initiation time was shorter, the angle of the clot was greater but there was a decrease in clot strength. The time to maximum clot strength and total clot strength was lower in low-carbohydrate high-fat diet relative to controls. The results show that a low-carbohydrate high-fat diet may induce inflammation leading to a predisposition to hypercoagulability increasing the likelihood of the formation of an abnormal clot.