Table 2.
Relation between diet and AF
| Study | Design | Subjects | FU | Intervention | AF risk (95% CI) | Comment |
|---|---|---|---|---|---|---|
| (a) Population cohorts | ||||||
| Shen et al.35 Framingham Heart Study |
Prospective | 4526 from original and off-spring cohort; participants without AF | 4 yrs | None | No association with alcohol, caffeine, fibre and fish-derived polyunsaturated fatty acids; limited attributable risk of AF>4 servings of dark fish/wk had HR 6.53 (2.65–16.06) vs. <1 serving |
Alcohol, caffeine, fibre, and fish-derived polyunsaturated fatty acids were not associated with AF risk |
| Khawaja et al.36 Physicians' Health Study |
Prospective | 21 054 men | 20 yrs (median 24 yrs) | None | - | No association between nut consumption and incident AF |
| Fretts et al.37 Cardiovascular Health Study |
Prospective | 4337 >65 years; no prevalent CHD or AF |
up to 19 yrs | None | - | No association between plasma phospholipid or dietary alpha linoleic acid and incident AF |
| Costanzo et al.38 | Prospective | 217; cardiac surgery | ICU stay +1 wk post-surgery unit | None | Highest tertile of dietary total antioxidant capacity vs. 2 lowest tertiles: OR 0.46 (0.22–0.95) |
Antioxidant-rich foods are associated with reduced incidence of post-operative AF |
| Mattioli et al.39 | Case–control | 800; 400 first detected AF episode | – | None | (a) OR 1.9 (1.58–2.81) (b) OR 1.8 (1.56–2.99) |
(a) Lower adherence to Mediterranean diet and lower antioxidant intake in patients with AF compared to control population; (b) Patients with arrhythmia who had higher Mediterranean score had higher probability of spontaneous conversion from AF to sinus rhythm |
| Pastori et al.40 | Prospective | 709 anticoagula-ted pts with AF | 39.9 months | None | – | Reduction in CV events; antioxidant effects such as down-regulation of NOX2 and decreased excretion of F2-isoprostanes |
| (b) Intervention studies | ||||||
| Martínez-González et al.41 PREDIMED- Prevención con Dieta Mediterránea |
Randomized primary prevention trial; post hoc analysis | 6705 | Median 4.7 yrs | Three diets: Mediterranean diet enriched with extra virgin olive oil, or mixed nuts; control group |
Mediterranean diet enriched with extra virgin olive oil vs. mixed nuts; HR 0.89 (0.65–1.2) Mediterranean diet enriched with extra virgin olive oil vs. control group: HR 0.62 (0.45–0.85) |
Mediterranean diet with olive oil reduced AF risk compared with control group; however, with no effect in a group with nuts Reduced incidence of stroke, myocardial infarction, and CV mortality; consumption of extra virgin olive oil but not nuts was associated with a lower risk of AF |
AF, atrial fibrillation; CHD, coronary heart disease; CI, confidence interval; CV, cardiovascular; FU, follow-up; HR, hazard ratio; ICU, intensive care unit; OR, odds ratio; pts, patients; wk, week; yrs, years.