Explanation
The RDW to platelets ratio is used as a measure of inflammation. (source)
Low
A low RDW/platelets ratio can be influenced by physiological factors relating to bone marrow, where platelets are produced, and red blood cell turnover, which is measured by RDW. From a nutritional perspective, deficiencies in vitamins and minerals essential for blood cell production, such as iron, folate, and vitamin B12, can contribute to alterations in these parameters. (source, source, source, source)
Optimization
Incorporate cocoa: Cocoa consumption has been shown to inhibit platelet activity pathways. (source) Cocoa acts as an anticoagulant, as it contains flavonoids that inhibit platelet aggregation and thus decrease platelet concentrations in the blood. (source) Recommendation: Consume at least 2.5 g of polyphenol-rich cocoa once daily.
Perform breathwork and/or meditation: Breathwork has been shown to lower markers of stress. (source) Mental stress has been shown to increase platelet count. (source) Meditation and breathwork have been shown to decrease cortisol levels, which are elevated during stress, and thus decrease platelet concentrations. (source) Recommendation: Sit down and calmly focus on your breath while box breathing for up to five minutes.
Supplement with fish oil: Omega-3 fatty acid supplementation has been shown to affect platelet activity. (source) Omega-3 fatty acids, particularly EPA and DHA, get incorporated into platelet phospholipids, which helps reduce platelet aggregation and decreases platelet concentrations. (source, source) Recommendation:Supplement with at least 3 grams of fish oil daily.
High
An elevated RDW-to-platelets ratio may be due to physiological factors affecting bone marrow causing imbalances within the body's blood composition. From a nutritional perspective, deficiencies in key nutrients involved in blood cell formation, such as iron or certain B vitamins, can impact this ratio. (source, source, source, source, source)
Optimization
Prioritize vitamin C-rich foods: High RDW has been associated with low vitamin C. (source) Vitamin C is an antioxidant that protects red blood cells from damage, which reduces cell size variability and thus RDW. (source) Recommendation: Consume at least one serving of foods high in vitamin C daily.
One serving examples: Red Bell Peppers (chopped) (1 cup), Strawberries (8 medium strawberries), Orange (1 medium orange), Grapefruit (½ large grapefruit), Citrus Juice (100%) (½ cup)
Avoid alcohol: Alcohol consumption is associated with higher measures of RDW. (source) Alcohol changes the structure of red blood cells which is reflected in RDW measurements. (source, source, source) Limiting the intake of alcohol reduces RDW. Recommendation: Monitor alcohol intake. Try to limit consumption to one or two drinks daily, with the goal of less than three per week.
Avoid smoking: Smokers have been shown to have elevated RDW. (source) Smoking causes oxidative stress, which leads to a variation in red blood cell size and ultimately raises RDW levels. (source) Avoiding smoking will normalize RDW. Recommendation: If a smoker, take the steps to quit. If not, avoid areas where secondhand smoke is present.
Prioritize sleep: Sleep duration has been shown to be associated with RDW. (source) Sleep disturbance is associated with increased inflammation and oxidative stress, which negatively affects red blood cell production and increases RDW. (source, source) Prioritizing sleep will positively affect RDW. Recommendation: Strive to get 8 to 10 hours of sleep for optimal recovery and adaptation.
Supplement with vitamin C: Low vitamin C levels have been associated with high RDW. (source) Vitamin C is an antioxidant that protects red blood cells from damage, which decreases cell size variability. (source) Supplementation with vitamin C reduces RDW. Recommendation: Supplement with at least 100 mg of vitamin C daily.
Prioritize foods high in folate: Consumption of folic acid has been shown to increase platelet count. (source) Folate aids in cell division in the bone marrow, the site of platelet production, which allows for increased platelet production. (source) Recommendation: Consume at least two servings of foods high in folate daily.
One serving examples: Beef Liver (3 oz), Lentils (1 cup), Black-Eyed Peas (1 cup), Asparagus (cooked) (1 cup), Spinach (2 cups)
Train regularly: Moderate and vigorous exercise is associated with increased platelet count. (source) Exercise causes a release of platelets from the liver, lungs, and spleen, due to increases in epinephrine, thus increasing platelet concentrations in the blood. (source) Recommendation: Follow a structured training program that exerts your body through multiple resistance and aerobic intensities. This includes a structured aerobic program that ensures at least 150 minutes of moderate intensity (50 to 70% max heart rate) or 75 minutes of high intensity (75% max heart rate or greater) a week and a structured resistance training program with moderate to heavy loads at least twice a week for resistance training. The final set of each resistance training exercise should be taken within two repetitions of failure.
Supplement with a vitamin B complex: Folic acid supplementation has been shown to increase platelet count. (source) Folate aids in cell division in the bone marrow, the site of platelet production, which allows for increased platelet production. (source) Recommendation: Supplement with a vitamin B complex that has at least 50% of daily recommendations for each B vitamin.
