Associations of dietary patterns, ultra-processed food and nutrient intake with incident atrial fibrillation

Author:

Tu Samuel JORCID,Gallagher Celine,Elliott Adrian DORCID,Bradbury Kathryn E,Marcus Gregory M,Linz DominikORCID,Pitman Bradley M,Middeldorp Melissa E,Hendriks Jeroen MORCID,Lau Dennis H,Sanders PrashanthanORCID,Wong Christopher X

Abstract

ObjectiveTo examine the associations between specific dietary patterns and incident atrial fibrillation (AF).MethodsUsing data from the UK Biobank, dietary intakes were calculated from 24-hour diet recall questionnaires. Indices representing adherence to dietary patterns (Mediterranean-style, Dietary Approaches to Stop Hypertension (DASH) and plant-based diets) were scored, and ultra-processed food consumption was studied as a percentage of total food mass consumed. Incident AF hospitalisations were assessed in Cox regression models.ResultsA total of 121 300 individuals were included, with 4 579 incident AF cases over a median follow-up of 8.8 years. Adherence to Mediterranean-style or DASH diets was associated with a lower incidence of AF in minimally adjusted analyses (HR for highest vs lowest quintile 0.87 (95% CI 0.80–0.96) and HR 0.78 (95% CI 0.71–0.86), respectively). However, associations were no longer significant after accounting for lifestyle factors (HR 0.95 (95% CI 0.87–1.04) and 0.94 (95% CI 0.86–1.04) respectively), with adjustment for body mass index responsible for approximately three-quarters of the effect size attenuation. Plant-based diets were not associated with AF risk in any models. Greatest ultra-processed food consumption was associated with a significant increase in AF risk even in fully adjusted models (HR 1.13 (95% CI 1.02–1.24)), and a 10% increase in absolute intake of ultra-processed food was associated with a 5% increase in AF risk (HR 1.05 (95% CI 1.01–1.08)).ConclusionWith the possible exception of reducing ultra-processed food consumption, these findings suggest that attention to other modifiable risk factors, particularly obesity, may be more important than specific dietary patterns for the primary prevention of AF.

Funder

Hospital Research Foundation

National Heart Foundation of Australia

National Health and Medical Research Council of Australia

American Association for Women

University of Adelaide

Publisher

BMJ

Subject

Cardiology and Cardiovascular Medicine

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