Dietary factors and incident atrial fibrillation: the Framingham Heart Study

Shen, Jian; Johnson, Victoria; Sullivan, Lisa M.; Jacques, Paul F.; Magnani, Jared W.; Lubitz, Steven A.; Pandey, Shivda; Levy, Daniel; Vasan, Ramachandran S.; Quatromoni, Paula A.; Junyent, Mireia; Ordovas, José M.; Benjamin, Emelia J.

doi:10.3945/ajcn.110.001305

Cited by 112 publications

(103 citation statements)

References 47 publications

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“…We did not separately assess risk of AF according to physical activity intensity, and these differences can not be excluded in this cohort as well. Similar to our study, prior literature has not demonstrated a reliable association between either total cholesterol or dietary components and AF 36, 37, 38, 39, 40, 41, 42. No previous studies have explored whether specific dietary patterns might be associated with the risk of AF.…”

Section: Discussionsupporting

confidence: 86%

American Heart Association's Life Simple 7 and Risk of Atrial Fibrillation in a Population Without Known Cardiovascular Disease: The ARIC (Atherosclerosis Risk in Communities) Study

Garg

O’Neal

Chen

et al. 2018

JAHA

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BackgroundThe American Heart Association has defined metrics of ideal cardiovascular health known as Life's Simple 7 (LS7) to prevent cardiovascular disease. We examined the association between LS7 and incident atrial fibrillation (AF) in a biracial cohort of middle‐ and older‐aged adults without known cardiovascular disease.Methods and ResultsThis analysis included 13 182 ARIC (Atherosclerosis Risk in Communities) study participants (mean baseline age=54±5.7 years; 56% women; 25% black) free of AF and cardiovascular disease. An overall LS7 score was calculated as the sum of the LS7 component scores and classified as inadequate (0‐4), average (5‐9), or optimal (10‐14) cardiovascular health. The primary outcome was incident AF, identified primarily by ECG and hospital discharge coding of AF through December 31, 2014. A total of 2266 (17%) incident AF cases were detected over a median follow‐up of 25.1 years. Compared with the inadequate category (n=1057), participants in the average (n=8629) and optimal (n=3496) categories each had a lower risk of developing AF in a multivariable Cox proportional hazards model (hazard ratio 0.59, 95% confidence interval 0.51, 0.67 for average; and hazard ratio 0.38, 95% confidence interval 0.32, 0.44 for optimal). In a similar model, a 1‐point‐higher LS7 score was associated with a 12% lower risk of incident AF (hazard ratio 0.88, 95% confidence interval 0.86, 0.89).ConclusionsA higher LS7 score is strongly associated with a lower risk of AF in individuals without baseline cardiovascular disease. Determining whether interventions that improve the population's cardiovascular health also reduce AF incidence is needed.

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Section: Discussionsupporting

confidence: 86%

American Heart Association's Life Simple 7 and Risk of Atrial Fibrillation in a Population Without Known Cardiovascular Disease: The ARIC (Atherosclerosis Risk in Communities) Study

Garg

O’Neal

Chen

et al. 2018

JAHA

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“…Previous epidemiological assessments of dietary exposures in relation to AF have obtained inconsistent results. [23][24][25] A potential protective effect of long chain omega-3 fatty acids from fish, especially docosahexaenoic acid, has been suggested in some 26,27 but not all [23][24][25]28,29 studies. To the best of our knowledge, there are no data from observational epidemiological studies to support or refute an association between EVOO consumption and reduced AF risk.…”

Section: Discussionmentioning

confidence: 99%

Extravirgin Olive Oil Consumption Reduces Risk of Atrial Fibrillation

Martínez‐González¹,

Arós²,

Fiol³

et al. 2014

Circulation

196

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Background-The PREDIMED (Prevención con Dieta Mediterránea) randomized primary prevention trial showed that a Mediterranean diet enriched with either extravirgin olive oil or mixed nuts reduces the incidence of stroke, myocardial infarction, and cardiovascular mortality. We assessed the effect of these diets on the incidence of atrial fibrillation in the PREDIMED trial. Methods and Results-Participants were randomly assigned to 1 of 3 diets: Mediterranean diet supplemented with extravirgin olive oil, Mediterranean diet supplemented with mixed nuts, or advice to follow a low-fat diet (control group). Incident atrial fibrillation was adjudicated during follow-up by an events committee blinded to dietary group allocation. Among 6705 participants without prevalent atrial fibrillation at randomization, we observed 72 new cases of atrial fibrillation in the Mediterranean diet with extravirgin olive oil group, 82 in the Mediterranean diet with mixed nuts group, and 92 in the control group after median follow-up of 4.7 years. The Mediterranean diet with extravirgin olive oil significantly reduced the risk of atrial fibrillation (hazard ratio, 0.62; 95% confidence interval, 0.45-0.85 compared with the control group). No effect was found for the Mediterranean diet with nuts (hazard ratio, 0.89; 95% confidence interval, 0.65-1.20). Conclusions-In Clinical Perspective on p 26In spite of advances in our understanding of the pathophysiological mechanisms that cause AF, preventive strategies are virtually nonexistent.6 Lifestyle factors, especially dietary habits, have been recognized as important determinants of other major cardiovascular diseases (CVDs; stroke, coronary heart disease, and peripheral artery disease). Some of the salutary effects of diet and lifestyle modification for cardiovascular risk reduction are hypothesized to be mediated by reduction of inflammation and oxidative stress in association with the metabolic syndrome. Interestingly, the same mechanisms have been implicated in the pathogenesis of AF. [8][9][10] In this context, adherence to the traditional Mediterranean dietary pattern, with abundant consumption of vegetable fats such as extravirgin olive oil (EVOO), has been proven to reduce the incidence of major CVDs. 11,12 Recently, the PREDIMED (Prevención con Dieta Mediterránea) randomized primary prevention trial 13 showed that a Mediterranean diet (MeDiet) supplemented with either EVOO or mixed nuts was superior to a low-fat diet for prevention of stroke, myocardial infarction, or cardiovascular mortality 12 and for the reduction of peripheral artery disease.14 In a secondary analysis, we assessed the effect of the 2 supplemented MeDiets on the incidence of AF. Methods The PREDIMED Trial: Study Design and ParticipantsThe design, objectives, methods, and protocol of the PREDIMED study (http://www.predimed.es) have been reported in detail elsewhere. 12,13 This was a multicenter trial conducted in 11 recruiting centers affiliated with 11 Spanish university hospitals. Participants were 7447 men (aged ...

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“…The method of caffeine exposure ascertainment was unclear in the study performed by Wilhelmsen et al [15]. Two studies were conducted in the USA [16,17] and 6 in Europe (4 in Sweden [10,13,15], 1 in Denmark [18], and 1 in Italy [14]). The lengths of the 7 cohort studies were considered to be reasonable, with a mean follow-up ranging from 4 to 25 years.…”

Section: Description Of Studiesmentioning

confidence: 99%

Does Caffeine Consumption Increase the Risk of New-Onset Atrial Fibrillation?

Abdelfattah

Kamran²,

Lazar³

et al. 2018

Cardiology

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Objective: Caffeine has been considered a trigger for atrial fibrillation (AF). We conducted a meta-analysis including a dose-response analysis to assess the relationship between caffeine consumed and incidence of AF. Methods: Data from selected studies represented 176,675 subjects (AF in 9,987 [5.7%]). Caffeine content varied widely, ranging from 40 to 180 mg per cup of coffee. For purposes of the calculations in this study, we assumed 140 mg of caffeine in a standard 12-oz cup of coffee. Results: No significant difference was found in AF incidence when the subjects consuming less than 2 cups of coffee per day were compared to subjects with higher consumption, 1.068 (0.937–1.216). The risk of AF was higher among subjects consuming less than 2 cups of coffee daily when compared to higher daily consumption subjects. A lower incidence of AF was found among people consuming more than 436 mg daily. Conclusion: The incidence of AF is not increased by coffee consumption. In fact, we found a lower incidence of AF when caffeine consumption exceeded 436 mg/day. Therefore, based on available evidence there is no association between caffeine intake and AF risk.

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Dietary factors and incident atrial fibrillation: the Framingham Heart Study

Cited by 112 publications

References 47 publications

American Heart Association's Life Simple 7 and Risk of Atrial Fibrillation in a Population Without Known Cardiovascular Disease: The ARIC (Atherosclerosis Risk in Communities) Study

American Heart Association's Life Simple 7 and Risk of Atrial Fibrillation in a Population Without Known Cardiovascular Disease: The ARIC (Atherosclerosis Risk in Communities) Study

Extravirgin Olive Oil Consumption Reduces Risk of Atrial Fibrillation

Does Caffeine Consumption Increase the Risk of New-Onset Atrial Fibrillation?

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