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Deep Venous Thrombosis: Nutritional Considerations

DVT is rare in societies where diets are primarily based on unrefined plant foods, rather than on animal products or highly refined foods, and, as a result, are lower in fat and higher in dietary fiber.3,4 The reasons for this association are unclear. However, low fiber intake is associated with higher activity of plasminogen activator inhibitor-1 (PAI-1), the body's main inhibitor of fibrinolysis.5 Low-fat, high-fiber diets, combined with exercise, improve fibrinolysis,6,7 and may thereby help reduce DVT risk. Some hypothesize that individuals on low-fiber diets often strain to pass stools, raising intravenous pressures and damaging the valves that facilitate blood return.3 High-fiber diets help prevent this problem.

Two nutritional factors are associated with reduced risk of DVT, without clear evidence of cause and effect.

Low-fat, high-fiber diets. Elevated blood cholesterol concentrations are associated with DVT risk.8 Some evidence suggests that simultaneously elevated cholesterol and triglycerides increase this risk.9 Greatly reducing dietary cholesterol and saturated fat and increasing dietary fiber have a major effect on blood lipids. As explained here, low-fat, vegetarian and vegan diets are particularly effective in achieving this goal. Elevated fibrinogen levels, which is another risk factor for DVT,10 are lower in persons following vegetarian diets.11,12

Weight control. Obesity increases the risk for developing DVT.13,14 The risk may be due to an obesity-related increase in PAI-1,15 or to associated elevation of venous pressure. Click here for a discussion of weight-control techniques.

In addition, constancy of vitamin K intake is important for patients using warfarin anticoagulation. For this population, even small increases in dietary vitamin K appear capable of reducing INR to subtherapeutic levels.16 Conversely, decreased vitamin K may result in prolonged INR and increased bleeding risk. Food sources of vitamin K (mainly green vegetables) need not be eliminated, but vegetable intake should be consistent from day to day to avoid excessively low or high intakes. Patients should not take a vitamin K supplement without physician approval.

Orders

Vegetarian diet, low-fat, nondairy

Nutrition consultation to assist patient with diet changes, with outpatient follow up as needed.

See Basic Diet Orders chapter.

Individualized exercise prescription to manage cholesterol levels and decrease extended periods of immobility.

What to Tell the Family

Some evidence suggests that a health-promoting diet, regular exercise, and maintenance of a healthy weight may reduce the risk of DVT. Persons who are on medication to prevent DVT recurrence should follow similar diet and exercise measures, along with maintaining consistency in intake of vitamin K-containing foods. Family members will help adherence and improve their own health by adopting similar diet and exercise routines.

 

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