Dietary Fish and Long-Chain n-3 Polyunsaturated Fatty Acids Intake and Risk of Atrial Fibrillation: A Meta-Analysis

Abstract

Findings on the association between long-term intake of fish or long-chain n-3 polyunsaturated fatty acids (PUFAs) and risk of atrial fibrillation (AF) are inconsistent in observational studies. We conducted a meta-analysis of prospective studies to separately examine the associations between fish consumption and dietary intake of n-3 PUFAs with the risk of AF. A systematic search was conducted in PubMed and Embase to identify relevant studies. Risk estimates were combined using a random-effect model. Seven prospective cohort studies covering 206,811 participants and 12,913 AF cases were eligible. The summary relative risk of AF for the highest vs. lowest category of fish consumption and dietary intake of n-3 PUFAs was 1.01 (95% confidence interval: 0.94–1.09) and 1.03 (95% confidence interval: 0.97–1.09), respectively. These null associations persisted in subgroup and dose-response analyses. There was little evidence of publication bias. This meta-analysis suggests that neither long-term intake of fish, nor of n-3 PUFAs were significantly associated with lower risk of AF.

Atrial fibrillation risk factor management with a plant‐based diet: A review

“…26 Other studies, however, could not confirm these findings. 27,28 Results from the Framingham Heart Study revealed an even increased risk of developing AF in individuals who consumed more than four servings of dark fish per week. 17 The authors of this study concluded that their observations may even "suggest a true adverse effect" of fish oil and dark fish on certain subtypes of AF.…”

“…In 2004, the authors of a prospective, population‐based cohort study reported a beneficial association between AF and the intake of fish and fish‐derived polyunsaturated fatty acids . Other studies, however, could not confirm these findings . Results from the Framingham Heart Study revealed an even increased risk of developing AF in individuals who consumed more than four servings of dark fish per week .…”

N-3 Polyunsaturated Fatty Acids and Atrial Fibrillation: Friend or Foe?

“…Previously, our meta-analysis of ten RCTs found that n-3 PUFAs did not protect against incident or recurrent AF [3]. In real-world settings, a meta-analysis of seven prospective cohort studies also found no protection of n-3 PUFAs against AF development [4]. Yet, the Cardiovascular Health Study associated higher levels of n-3 PUFAs and a lower incidence of AF [5].…”

Plasma Phospholipid Fatty Acids and Risk of Atrial Fibrillation: A Mendelian Randomization Study

“…A systematic review of randomized controlled trials with 4677 patients showed that the OR of AF in the groups with n-3 PUFA supplementation was 0.95 (95% CI, 0.79, 1.13) for AF recurrence and 0.86 (95% CI, 0.71, 1.04) for postoperative AF, and strong heterogeneity between study results was detected [26]. Some observational studies have shown that high exposure to long-chain n-3 PUFAs decreases the risk of AF or AF recurrence [8,31], but a meta-analysis found no association between intake of long-chain n-3 PUFAs and AF risk [13]. Moreover, in a large-scale cohort of 72,984 Swedish adults with a 12 years follow-up period, dietary intake of n-3 PUFAs was not associated with a lower AF incidence after adjustment for other risk factors [10].…”

“…In a randomized controlled trial, involving 6705 individuals, the risk of AF was reduced by 38% in the group following a Mediterranean diet with high extra-virgin olive oil intake compared with the control group [9]. Nevertheless, most but not all observational studies observed null associations of dietary and circulating n-3 polyunsaturated fatty acid with the risk of AF [10,11,12,13]. In a cohort study of 72,984 Swedish adults followed for 12 years, high n-3 polyunsaturated fatty acid intake was not associated with incident AF in men and women [10].…”