Affiliation:
1. First Department of Cardiology, Athens University School of Medicine, Athens, Greece
2. Department of Psychiatry,
Eginition University Hospital, Athens, Greece
3. School of Medicine, Patras University, Patras, Greece
4. Central Laboratories,
Onassis Cardiac Surgery Center, Athens, Greece
Abstract
Abstract:
In addition to the association of dietary patterns, specific foods and nutrients with several
diseases, including cardiovascular disease and mortality, there is also strong emerging evidence of an
association of dietary patterns with the risk of sudden cardiac death (SCD). In this comprehensive review,
data are presented and analyzed about foods and diets that mitigate the risk of ventricular arrhythmias
(VAs) and SCD, but also about arrhythmogenic nutritional elements and patterns that seem to
enhance or facilitate potentially malignant VAs and SCD. The antiarrhythmic or protective group comprises
fish, nuts and other foods enriched in omega-3 polyunsaturated fatty acids, the Mediterranean and
other healthy diets, vitamins E, A and D and certain minerals (magnesium, potassium, selenium). The
arrhythmogenic-food group includes saturated fat, trans fats, ketogenic and liquid protein diets, the
Southern and other unhealthy diets, energy drinks and excessive caffeine intake, as well as heavy alcohol
drinking. Relevant antiarrhythmic mechanisms include modification of cell membrane structure by
n-3 polyunsaturated fatty acids, their direct effect on calcium channels and cardiomyocytes and their
important role in eicosanoid metabolism, enhancing myocyte electric stability, reducing vulnerability to
VAs, lowering heart rate, and improving heart rate variability, each of which is a risk factor for SCD.
Contrarily, saturated fat causes calcium handling abnormalities and calcium overload in cardiomyocytes,
while a high-fat diet causes mitochondrial dysfunction that dysregulates a variety of ion channels
promoting VAs and SCD. Free fatty acids have been considered proarrhythmic and implicated in facilitating
SCD; thus, diets increasing free fatty acids, e.g., ketogenic diets, should be discouraged and replaced
with diets enriched with polyunsaturated fatty acids, which can also reduce free fatty acids. All
available relevant data on this important topic are herein reviewed, large studies and meta-analyses and
pertinent advisories are tabulated, while protective (antiarrhythmic) and arrhythmogenic specific diet
constituents are pictorially illustrated.
Publisher
Bentham Science Publishers Ltd.
Subject
Cardiology and Cardiovascular Medicine,Pharmacology
Cited by
1 articles.
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