Published Review Article by The AFIP Foundation: Diet-Based Solutions for AFib

On August 13th, 2024, a scientific review article, led by the AFIP Foundation in close collaboration with patient advocacy groups Plant-Powered Metro New York and Plant-Based Pittsburgh, was published in the Nutrients journal. This work that discussed diet-based solutions for atrial fibrillation (Afib) was part of the broader efforts of the CIRCULAR Consortium. Here is a brief summary of the main topics discussed in the article.

Key points:

Here are the key takeaways from this article:

Reducing Afib risk factors through diet

Mediterranean diet and Afib

The Mediterranean diet is primarily composed of plant-based foods, such as fruits, vegetables, whole grains, legumes, and nuts. It also includes moderate consumption of fish and poultry, with a minimal intake of red meat. Olive oil is the main source of fat, and wine is consumed in moderation. This diet is rich in antioxidants, fiber, and healthy fats, which contribute to its well-known benefits for heart health and longevity.

A recently published PREDIMED study demonstrates that adhering to a Mediterranean diet results in lower epicardial adipose tissue (EAT), with high levels of epicardial adipose tissue being associated with persistent atrial fibrillation. The findings indicate a potential health benefit of a Mediterranean diet in reducing the incidence as well as possible risk factors associated with Afib.

A whole foods plant-based diet and Afib

The whole foods plant-based diet emphasizes whole, minimally processed foods derived from plants, including fruits, vegetables, whole grains, legumes, nuts, and seeds. It typically excludes or significantly reduces the intake of animal products. This diet is associated with numerous health benefits, such as reduced risk of chronic diseases, due to its high content of vitamins, minerals, and fiber. Due to the reported beneficial effects of a plant-based diet on cardiac health, this diet has gained increasing attention from the medical community.

An illustrative case of how a plant-based diet can lower risk is demonstrated in the research conducted by Pathak et al. Their study describes that Afib patients who lost more than 10% of their body weight experienced a sixfold increase likelihood of remaining Afib-free, compared to patients who lost less than 10% during the same timeframe. Sustained weight loss also ensures that patients have a normal sinus rhythm for a longer period of time.

The effect of diet on modifiable risk factors for atrial fibrillation

Key risk factors for Afib include hypertension, diabetes, and obesity, many of which are linked to lifestyle choices, suggesting that lifestyle modifications, including diet, could reduce Afib symptoms and episodes.

Both diets, which emphasize unprocessed plant foods, have shown potential in reducing Afib risk factors. The Mediterranean diet has been particularly noted for lowering the incidence of atrial fibrillation, while plant-based diets have been linked to improvements in hypertension, diabetes, obesity, and inflammation.

The thickness of EAT, a layer of fat located between the outer surface of the heart (epicardium) and the protective membrane surrounding it (pericardium), has been connected with the incidence and severity of Afib. Given its anatomical tendency to build up on the left atrium, EAT has been implicated as a significant risk factor in the development of Afib. Lifestyle changes, in particular, diet changes, have been associated with reduced EAT.

Quality of life-centered solution for AFib and Citizen science

A shift towards quality-of-life-centered treatment approaches, including dietary and lifestyle adjustments, empowers patients to take control of their health, leading to better management of AFib and overall well-being.

Patients have explored and reported benefits from using L-glutamine and electrolytes, such as magnesium, for managing Afib. These initiatives highlight the value of patient empowerment and a holistic approach to treatment.

Throughout the CIRCULAR project, patients remain at the center in every stage of the cycle. The figure below depicts how patients are integrated within this holistic Afib research. This is called the CIRCULAR patient and researcher collaboration model.

The rise of citizen science in healthcare allows patients to co-create personalized treatment plans, leading to more inclusive and effective atrial fibrillation management strategies. Citizen science bridges the divide between patients, researchers, and health practitioners, allowing patients to become major stakeholders in research and development processes. Patient-reported outcomes have spurred new research and collaborations, emphasizing the importance of patient-centered care.

The study concluded that both Mediterranean and plant-based diets significantly reduce key risk factors for Afib, such as hypertension, diabetes, and epicardial adipose tissue. These dietary approaches offer effective, non-invasive methods for managing atrial fibrillation. Additionally, patient empowerment and citizen science are critical for developing personalized, sustainable treatment strategies. The integration of lifestyle changes, particularly diet, plays a pivotal role in improving Afib outcomes.

References

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