 In the prevention of cardiovascular disease, the consumption of fruits and vegetables is crucial. Yes, preventing the oxidation of cholesterol may be one of the mechanisms by which fruits and vegetables reduce the risk of heart attacks and strokes. However, hyperactivity of platelets is also critically important in the development of cardiovascular disease, as I've covered before. In recent years, it has been shown that platelets are not only involved in the clotting process, but also they play an active role in the inflammatory process of atherosclerosis from the beginning, and that means from childhood. By the end of our teens, atherosclerotic lesions are present in most people living in industrialized societies, and so suppressing the overactivity of platelets may be beneficial not only for heart disease, but for cancer and allergies, and other diseases for which inflammation plays a major role. The antioxidant properties of fruits and veggies are well known, however their anti-clotting effects on platelets are less known. Preliminary studies have demonstrated the platelet activation suppressing activity of a variety of fruits and vegetables. So much so, they can mess up platelet function tests, and the effects are so long-lasting, just fasting the mourning of your blood test may not be sufficient. Out of the 16 different fruits tested, tomatoes came out number one. The anti-platelet activation components of tomatoes are water-soluble, so you don't have to eat them with fat. Heat-stable, meaning you can cook tomatoes without losing the benefits, and concentrated in the yellow fluid around the seeds, which is why tomato pumice, beat-out tomato juice, sauce, or ketchup, pumice is basically the seeds and the peel which the industry throws away, and it may be the healthiest part. The more tomato seeds, the better. But this was measuring platelet activation in a Petri dish. Grapefruit came in number two here, and grapefruit juice, at least, did not appear to help when people actually drank it. So would drinking tomato juice actually help? Yes, platelets of people with diabetes are characterized by intensified activation, so 20 diabetics were asked to drink a daily cup of tomato juice for three weeks, or a tomato-flavored placebo beverage. And there was a significant drop in platelet activation in the real juice group. Works in healthy people, too. Within three hours of consumption, two tomatoes are good, but six tomatoes are better, and the effects were more wide-ranging than those of aspirin, and that tomatoes target multiple pathways of platelet activation. About one in four people are so-called aspirin-resistant, meaning aspirin doesn't work to calm down their platelets, whereas only 3% of study subjects were found to be tomato-resistant. This finding indicates an advantage of the tomato extracts broad anti-platelet activity profile over single-target drugs, such as aspirin. And when researchers stuck tubes into people while they were eating tomatoes, they found no changes in blood clotting times, implying that supplementation with tomatoes should not result in prolonged bleeding time. So one might get the best of both worlds, less platelet activation, without the bleeding risk. But if tomatoes don't thin our blood, do they work? Consumption of tomato products has been found to be protectively correlated with a lower incidence of acute coronary events, less development of early atherosclerosis, and lower mortality from heart disease. If you don't like tomatoes, kiwifruit recently beat them out in a test tube study of platelet activation. Strawberries may help too, but we have data showing kiwis may actually work in people too, and two kiwis appeared to work just as well as three kiwis. It appeared to work for green on the inside kiwifruit and for yellow on the inside kiwifruit. In this case, though, only one a day seemed to help, whereas two a day did not, which seems a little strange, and there haven't been any studies to see if kiwifruit eaters actually have fewer strokes and heart attacks. So the best evidence for dietary intervention to decrease platelet activation currently rests with tomatoes.