Mediterranean Diet and Atrial Fibrillation: Lessons Learned from the AFHRI Case–Control Study

Abstract

A relationship between lifestyle, diet, and atrial fibrillation (AF) remains unclear. Except for alcohol consumption, AF guidelines do not differentiate specific advice for this rhythm disorder. The aim of this study was to investigate the association between adherence to healthy dietary patterns and the presence of AF, among 104 low risk participants from the 1:1 matched case–control AFHRI (Atrial Fibrillation in High-Risk Individuals) study. Dietary data were obtained using a three-day food record. Adapted German versions of the validated 14-item Mediterranean Diet Adherence Screener (MEDAS) and the validated eight-item Healthy Eating Index (HEI) from the Epic Study served as the basis for data derivation. The median age of the study participants was 63.0 years, 73.1% were men. In multivariable adjusted binary logistic regression analyses, we found inverse associations between both dietary indices (MEDAS: Median = 3, HEI: Median = 54.9) and the presence of AF (odds ratio for MEDAS: 0.65, 95% confidence interval (CI): 0.47–0.91, odds ratio for HEI: 0.60, 95% CI 0.39–0.95). Further clinical studies are needed to confirm the extent to which high quality dietary patterns such as a Mediterranean diet influence the onset and natural history of AF, in order to provide dietary counselling.

Beneficial effects associated to a healthy lifestyle in systemic lupus erythematosus: A cross-sectional study

“…36 In line with this, German studies reported a median MEDAS as low as three points. 20 We -D) and functional status (FFbH) by bootstrapping according to Lindemann, Merenda and Gold (1980, p.119ff, Relaimpo-Package R). For instance, the association of the PCS to the three components of a healthy lifestyle is estimated to be equally attributable to non-smoking, healthy diet and activity (around 30%), while activity is mainly responsible for the association of the functional status to a healthy lifestyle (around 60%) therefore chose the cut-off for the MEDAS in the current study to delineate a healthy lifestyle at four or higher.…”

“…19 Patients may also benefit from other dietary patterns such as a traditional Asian diet, 19 gluten-free and vegan diet or fasting. 2 We did not account for these alternative potentially healthy dietary patterns, because previous studies in SLE mainly focused on a healthy Mediterranean diet, 2 we considered the latter pattern to likely be the most common amongst the healthy dietary patterns in Germany, 20,32 and due to practicality issues. As all patients in the study were Caucasian and German residents, we assumed alternative diets to be substantially less common in the present study.…”

“…36 In line with this, German studies reported a median MEDAS as low as three points. 20 We therefore chose the cut-off for the MEDAS in the current study to delineate a healthy lifestyle at four or higher.…”

“…15 Smoking status and duration were noted. Based on previous publications on the topic 16–20, requirements of a healthy lifestyle were defined as follows: at least 1 h of sport per week, a MEDAS of at least 4 and no current smoking. The SLE cohort was accordingly split into a ‘healthy lifestyle’ and ‘unhealthy lifestyle’ group based on whether these criteria were met.…”

Advances in the study of the effects of chronic periodontitis on cardiac arrhythmias

“…In addition, antibodies against heat shock protein 60 (HSP-60) expressed by periodontal pathogens can cross-react with hSP-60 in the host body to activate T cells, leading to endothelial damage and atherosclerotic plaque formation and mediating cardiovascular disease. However, whether MMPs or HSP-60-related immune responses of periodontal pathogens play important roles in atrial fibrillation remains unclear [27][28][29] .…”