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

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dc.contributor.authorTu, S.J.
dc.contributor.authorGallagher, C.
dc.contributor.authorElliott, A.D.
dc.contributor.authorBradbury, K.E.
dc.contributor.authorMarcus, G.M.
dc.contributor.authorLinz, D.
dc.contributor.authorPitman, B.M.
dc.contributor.authorMiddeldorp, M.E.
dc.contributor.authorHendriks, J.M.
dc.contributor.authorLau, D.H.
dc.contributor.authorSanders, P.
dc.contributor.authorWong, C.X.
dc.date.issued2023
dc.descriptionPublished Online First 17 July 2023
dc.description.abstractOBJECTIVE: To examine the associations between specific dietary patterns and incident atrial fibrillation (AF). METHODS: Using 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. RESULTS: A 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)). CONCLUSION: With 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.
dc.description.statementofresponsibilitySamuel J Tu, Celine Gallagher, Adrian D Elliott, Kathryn E Bradbury, Gregory M Marcus, Dominik Linz, Bradley M Pitman, Melissa E Middeldorp, Jeroen M Hendriks, Dennis H Lau, Prashanthan Sanders, Christopher X Wong
dc.identifier.citationHeart, 2023; 109(22):1683-1689
dc.identifier.doi10.1136/heartjnl-2023-322412
dc.identifier.issn1355-6037
dc.identifier.issn1468-201X
dc.identifier.orcidTu, S.J. [0000-0003-4137-1978]
dc.identifier.orcidGallagher, C. [0000-0002-5114-400X]
dc.identifier.orcidElliott, A.D. [0000-0002-5951-4239]
dc.identifier.orcidLinz, D. [0000-0003-4893-0824]
dc.identifier.orcidPitman, B.M. [0000-0001-6610-3473]
dc.identifier.orcidMiddeldorp, M.E. [0000-0002-4106-9771]
dc.identifier.orcidHendriks, J.M. [0000-0003-4326-9256]
dc.identifier.orcidLau, D.H. [0000-0001-7753-1318] [0000-0002-1564-439X]
dc.identifier.orcidSanders, P. [0000-0003-3803-8429]
dc.identifier.orcidWong, C.X. [0000-0002-1913-6675]
dc.identifier.urihttps://hdl.handle.net/2440/139166
dc.language.isoen
dc.publisherBMJ
dc.relation.grantNHMRC
dc.rights© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.
dc.source.urihttps://doi.org/10.1136/heartjnl-2023-322412
dc.subjectatrial fibrillation
dc.subjectepidemiology
dc.subjectrisk factors
dc.titleAssociations of dietary patterns, ultra-processed food and nutrient intake with incident atrial fibrillation
dc.typeJournal article
pubs.publication-statusPublished

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