Low White Blood Cell Count And Hemoglobin – B cell epitope mapping for non-specific lipid transfer proteins from legumes consumed in India and identification of critical residues responsible for IgE binding

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Low White Blood Cell Count And Hemoglobin

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Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain

Department of Nutrition, Food Science and Gastronomy, XaRTA, INSA, Faculty of Pharmacy and Food Sciences, University of Barcelona, ​​​​08028 Barcelona, ​​​​Spain

Bioarab Health Research Institute, Osakidetza Basque Health Service, Araba University Hospital, University of the Basque Country UPV/EHU, 01009 Vitoria-Gasteiz, Spain

We aimed to evaluate the effects of the antioxidant-rich Mediterranean diet (MedDiet) on white blood cell counts. Our study population included participants in the PREvención con DIeta MEDiterránea study (mean age 67 years, 58% women, high cardiovascular risk). We assessed whether a MedDiet intervention enriched in extra virgin olive oil or walnuts, compared with a low-fat control diet, altered the incidence of leukocytosis (>11 × 10).

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Leukocytes/L) in disease-free subjects at baseline (n = 3190, n = 2925, and n = 3190, respectively). We also examined whether the MedDiet modified the association between changes in white blood cell count and all-cause mortality. Both MedDiet interventions were associated with a lower risk of developing leukopenia (incidence rates: 5.06% in the control diet, 3.29% in the combined MedDiet groups; hazard ratio [95% confidence interval]: 0, 54 [0.36–0.80]) and severe leukopenia (incidence). rates: 1.26% in control diet, 0.46% in combined MedDiet groups; hazard ratio: 0.25 [0.10–0.60]). High cumulative adherence to a medical diet was related to a lower risk of leukocytosis (incidence rates: 2.08% in quartile 1, 0.65% in quartile 4; HR

: 0.29 [0.085–0.99]) and attenuated the association between leukopenia and all-cause mortality (P-interaction = 0.032). In short, the MedDiet decreased the incidence of white blood cell count changes in people at high cardiovascular risk.

There is increasing evidence that diet can modulate the immune system response [1, 2]. Experimental and clinical research in nutritional immunology has identified several dietary components such as dietary antioxidants (vitamin E, some phenolic compounds), omega-3 polyunsaturated fatty acids, folate, vitamin A, zinc, and probiotics as modifiable factors able to influence function immune. [3, 4, 5, 6, 7, 8]. However, the immunomodulatory effects of some of these nutrients have not yet been proven beyond low-grade inflammation (especially for vitamin E and phenolic antioxidants) [3, 4, 9, 10]. Combining these functionally diverse bioactive compounds in a healthy dietary pattern such as the Mediterranean diet (MedDiet) may be a sound strategy to promote overall immune system function. In observational studies, adherence to the MedDiet has been consistently associated with lower rates of cardiovascular disease [11], cancer [12], and all-cause mortality [13]. There is also first-level evidence from the large-scale randomized clinical trial PREDIMED (PREvención con DIeta MEDiterránea) on the effectiveness of the MedDiet to reduce incident cardiovascular disease [14], type 2 diabetes [15] and certain types of cancer. 16] in elderly people with high cardiovascular risk. Adherence to a medical diet has also been associated with improvements in other immune-related responses such as cytokine patterns [17, 18], gut-derived immunity [19] and thrombosis [20, 21]. Better functioning of the immune system could be a mediator of these beneficial effects [22, 23, 24, 25]. However, no intervention studies have evaluated the effects of the MedDiet on other immune-related responses such as white blood cell (WBC) count. High and low white blood cell counts have been associated with increased mortality [ 26 , 27 , 28 , 29 ] and are related to inappropriate immune system responses. On the one hand, the high number is closely related to chronic low-grade inflammation [30] and the incidence of inflammation-related diseases in the general population and in people at high cardiovascular risk [31]. On the other hand, low leukocyte levels are associated with nutritional deficiencies, chronic use of certain medications, and various states of immune dysfunction, such as autoimmune diseases, cancers of the immune system, infections, and diseases of the bone marrow, spleen, and blood. 32, 33]. WBC counts have been shown to be potentially modulated by changes in nutritional status in cross-sectional or short-term studies [32, 33]. Thus, an improvement in white blood cell counts and related conditions after following a medical diet is plausible.

Our primary aim was to evaluate the association of MedDiet with white blood cell count in middle-aged and older persons at high cardiovascular risk participating in the PREDIMED study. Our secondary aim was to determine whether following a Med diet modulated the association between changes in WBC count and all-cause mortality.

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The study population participated in the PREDIMED study. It was a multicenter, randomized, controlled trial conducted in Spain that evaluated the effects of the MedDiet intervention on the primary prevention of cardiovascular outcomes in individuals at high cardiovascular risk. Specifically, three intervention arms were compared: (1) a MedDiet enriched with extra virgin olive oil (MedDiet–EVOO), (2) a MedDiet enriched with mixed nuts (MedDiet–Nuts), and (3) a control with Low fat weight loss cure. Eligible participants were men (aged 55–80 years) and women (aged 60–80 years) with no history of severe cardiovascular disease at baseline but with type 2 or three or more diabetes many of the following risk factors: smoking, high blood pressure, low-density lipoprotein cholesterol ≥160 mg/dL, high-density lipoprotein cholesterol ≤40 mg/dL, overweight/obesity, and family history of premature coronary heart disease [14, 34]. Enrollment began on June 25, 2003, and the last participant was recruited on June 30, 2009. The PREDIMED trial was registered under International Standard Randomized Controlled Trial Number ISRCTN35739639. The study protocol adhered to the Declaration of Helsinki and was approved by the institutional review boards of all recruiting centers. An institutional ethics commission (CEIC-PSMAR) approved the particular protocol of this subproject (code: 2018/8180/I, date: December 4, 2018). The study protocol, recruitment methods and data collection processes have been described elsewhere [14, 34]. All volunteers provided written informed consent before joining the trial.

The purpose of this substudy is to investigate the effects of MedDiet on white blood cell count, which was not a predetermined.

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