Emerging data demonstrates a clear association between atrial fibrillation (AF) and lifestyle risk factors. Contemporary studies have observed that weight is a primary driver for AF in the Western world, with impacts on the AF substrate exacerbated by weight fluctuation1 and concomitant lifestyle risk factors. Additionally, weight loss1 2 and aggressive risk factor modification enable reverse remodelling of the atrial substrate that can reduce AF burden and even reverse the AF phenotype.3
Data evaluating the impacts of dietary intake on AF are limited. Post hoc analysis of the recent PREDIMED (Primary Prevention of Cardiovascular Disease with a Mediterranean Diet Supplemented with Extra-Virgin Olive Oil or Nuts) randomised trial showed that a Mediterranean diet supplemented with olive oil reduced incident AF.4 Prior observational data of the arrhythmogenic impacts of a Mediterranean diet have been conflicted. Additionally, observational data suggest that caffeine is protective of incident AF.5 Recent randomised data demonstrate that alcohol abstinence among moderate drinkers results in reversal of atrial remodelling, improved AF symptom severity and reduction of AF burden. Furthermore, existing data have served to highlight variable AF risks with different alcoholic beverages, implying associations of AF risk with beverage constituents as well as with alcohol. This current prospective cohort study by Tu et al
6 extends our current understanding of diet by evaluating the impacts of ultraprocessed food on AF risk. Although there are clear limitations to any study that evaluates diet in a large cohort, this is a welcome addition to our present understanding of the interaction between diet and AF risk.
The authors used survey data from 121 300 participants …