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A U-shaped association between consumption of marine n-3 fatty acids and development of atrial fibrillation/atrial flutter-a Danish cohort study.
Europace 2014; 16(11):1554-61E

Abstract

AIMS

Previous studies have suggested a lower risk of atrial fibrillation (AF) with higher intakes of fish and marine n-3 polyunsaturated fatty acids (PUFAs), but the results have been inconsistent. The aim was to investigate the association between consumption of marine n-3 PUFA and development of AF.

METHODS AND RESULTS

A total of 57 053 Danish participants 50-64 years of age were enrolled in the Diet, Cancer, and Health Cohort Study between 1993 and 1997. Dietary intake of fish and marine n-3 PUFA was assessed by a semi-quantitative food frequency questionnaire. In total, 3345 incident cases of AF occurred over 13.6 years. Multivariate Cox regression analyses (3284 cases and 55 246 participants) using cubic splines showed a U-shaped association between consumption of marine n-3 PUFA and risk of incident AF, with the lowest risk of AF at a moderate intake of 0.63 g/day. For quintiles of marine n-3 PUFA intake, a 13% statistically significant lower risk of AF was seen in the middle vs. lowest quintile: Q1 reference, Q2 HR 0.92 (95% CI 0.82-1.03), Q3 HR 0.87 (95% CI 0.78-0.98), Q4 HR 0.96 (95% CI 0.86-1.08), and Q5 HR 1.05 (95% CI 0.93-1.18). Intake of total fish, fatty fish, and the individual n-3 PUFA eicosapentaenoic acid, docosahexaenoic acid, and docosapentaenoic acid also showed U-shaped associations with incident AF.

CONCLUSION

We found a U-shaped association between consumption of marine n-3 PUFA and risk of incident AF, with the lowest risk close to the median intake of total marine n-3 PUFA (0.63 g/day).

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    Authors+Show Affiliations

    Rix TA
    Department of Cardiology, Aalborg AF Study Group, Center for Cardiovascular Research, Aalborg University Hospital, 9100 Aalborg, Denmark Section for Epidemiology, Department of Public Health, Aarhus University, 8000 Aarhus, Denmark tar@rn.dk.
    Joensen AM
    Department of Cardiology, Aalborg AF Study Group, Center for Cardiovascular Research, Aalborg University Hospital, 9100 Aalborg, Denmark.
    Riahi S
    Department of Cardiology, Aalborg AF Study Group, Center for Cardiovascular Research, Aalborg University Hospital, 9100 Aalborg, Denmark Department of Health Science and Technology, Faculty of Medicine, Aalborg University, 9220 Aalborg, Denmark.
    Lundbye-Christensen S
    Department of Cardiology, Aalborg AF Study Group, Center for Cardiovascular Research, Aalborg University Hospital, 9100 Aalborg, Denmark.
    Tjønneland A
    Danish Cancer Society Research Center, 2100 Copenhagen, Denmark.
    Schmidt EB
    Department of Cardiology, Aalborg AF Study Group, Center for Cardiovascular Research, Aalborg University Hospital, 9100 Aalborg, Denmark.
    Overvad K
    Department of Cardiology, Aalborg AF Study Group, Center for Cardiovascular Research, Aalborg University Hospital, 9100 Aalborg, Denmark Section for Epidemiology, Department of Public Health, Aarhus University, 8000 Aarhus, Denmark.

    MeSH

    AnimalsAtrial FibrillationAtrial FlutterDenmarkDietDocosahexaenoic AcidsEicosapentaenoic AcidFatty Acids, Omega-3Fatty Acids, UnsaturatedFemaleFishesHumansIncidenceMaleMiddle AgedMultivariate AnalysisNonlinear DynamicsProportional Hazards ModelsProtective FactorsRegistriesRisk AssessmentRisk FactorsRisk Reduction BehaviorSeafoodSurveys and Questionnaires

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    24574493

    Citation

    Rix, Thomas A., et al. "A U-shaped Association Between Consumption of Marine N-3 Fatty Acids and Development of Atrial Fibrillation/atrial Flutter-a Danish Cohort Study." Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups On Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology, vol. 16, no. 11, 2014, pp. 1554-61.
    Rix TA, Joensen AM, Riahi S, et al. A U-shaped association between consumption of marine n-3 fatty acids and development of atrial fibrillation/atrial flutter-a Danish cohort study. Europace. 2014;16(11):1554-61.
    Rix, T. A., Joensen, A. M., Riahi, S., Lundbye-Christensen, S., Tjønneland, A., Schmidt, E. B., & Overvad, K. (2014). A U-shaped association between consumption of marine n-3 fatty acids and development of atrial fibrillation/atrial flutter-a Danish cohort study. Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups On Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology, 16(11), pp. 1554-61. doi:10.1093/europace/euu019.
    Rix TA, et al. A U-shaped Association Between Consumption of Marine N-3 Fatty Acids and Development of Atrial Fibrillation/atrial Flutter-a Danish Cohort Study. Europace. 2014;16(11):1554-61. PubMed PMID: 24574493.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - A U-shaped association between consumption of marine n-3 fatty acids and development of atrial fibrillation/atrial flutter-a Danish cohort study. AU - Rix,Thomas A, AU - Joensen,Albert M, AU - Riahi,Sam, AU - Lundbye-Christensen,Søren, AU - Tjønneland,Anne, AU - Schmidt,Erik B, AU - Overvad,Kim, Y1 - 2014/02/26/ PY - 2014/2/28/entrez PY - 2014/2/28/pubmed PY - 2015/6/30/medline KW - Atrial fibrillation KW - Diet KW - Fish KW - n-3 Polyunsaturated fatty acids SP - 1554 EP - 61 JF - Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology JO - Europace VL - 16 IS - 11 N2 - AIMS: Previous studies have suggested a lower risk of atrial fibrillation (AF) with higher intakes of fish and marine n-3 polyunsaturated fatty acids (PUFAs), but the results have been inconsistent. The aim was to investigate the association between consumption of marine n-3 PUFA and development of AF. METHODS AND RESULTS: A total of 57 053 Danish participants 50-64 years of age were enrolled in the Diet, Cancer, and Health Cohort Study between 1993 and 1997. Dietary intake of fish and marine n-3 PUFA was assessed by a semi-quantitative food frequency questionnaire. In total, 3345 incident cases of AF occurred over 13.6 years. Multivariate Cox regression analyses (3284 cases and 55 246 participants) using cubic splines showed a U-shaped association between consumption of marine n-3 PUFA and risk of incident AF, with the lowest risk of AF at a moderate intake of 0.63 g/day. For quintiles of marine n-3 PUFA intake, a 13% statistically significant lower risk of AF was seen in the middle vs. lowest quintile: Q1 reference, Q2 HR 0.92 (95% CI 0.82-1.03), Q3 HR 0.87 (95% CI 0.78-0.98), Q4 HR 0.96 (95% CI 0.86-1.08), and Q5 HR 1.05 (95% CI 0.93-1.18). Intake of total fish, fatty fish, and the individual n-3 PUFA eicosapentaenoic acid, docosahexaenoic acid, and docosapentaenoic acid also showed U-shaped associations with incident AF. CONCLUSION: We found a U-shaped association between consumption of marine n-3 PUFA and risk of incident AF, with the lowest risk close to the median intake of total marine n-3 PUFA (0.63 g/day). SN - 1532-2092 UR - https://www.unboundmedicine.com/medline/citation/24574493/A_U_shaped_association_between_consumption_of_marine_n_3_fatty_acids_and_development_of_atrial_fibrillation/atrial_flutter_a_Danish_cohort_study_ L2 - https://academic.oup.com/europace/article-lookup/doi/10.1093/europace/euu019 DB - PRIME DP - Unbound Medicine ER -