Dr. John Day, Cardiologist

Can a Mediterranean Diet Prevent Atrial Fibrillation from Coming Back After an Ablation?

Atrial fibrillation (AFib) is a common heart rhythm problem. After a procedure called AFib ablation, which aims to fix this issue, AFib can still come back in some patients. However, there might be a way to reduce this risk with the help of a Mediterranean diet. Let’s explore what a Mediterranean diet is, what a recent study says about it, and how it might help patients with AFib.

What is the Mediterranean Diet?

The Mediterranean diet is a way of eating inspired by the traditional foods of countries around the Mediterranean Sea, like Italy and Greece. This diet includes:

-Fruits and Vegetables: Fresh and colorful fruits and vegetables make up a large part of this diet.

-Whole Grains: Foods like whole wheat bread, brown rice, and oats.

-Healthy Fats: Mainly from olive oil, nuts, and seeds.

-Lean Proteins: Fish, especially those rich in omega-3 fatty acids like salmon, as well as poultry and legumes.

-Limited Red Meat: Red meat is eaten less often and in smaller amounts.

-Dairy: Usually in the form of cheese and yogurt, but in moderation.

-Herbs and Spices: Used to flavor food instead of salt.

The PREDIMAR Study

The PREDIMAR trial studied whether a Mediterranean diet could help prevent AFib from coming back after an ablation procedure. In this study, patients were divided into two groups:

1. Mediterranean Diet Group: Patients followed the Mediterranean diet and received extra-virgin olive oil (EVOO) for free. They also got support through phone calls and a website.

2. Control Group: Patients continued with their usual diet without specific guidance.

Results of the Study

The study involved 720 patients. Here’s what the researchers found:

1. Overall Recurrence: AFib came back in 34.8% of patients in the Mediterranean diet group and 37.5% in the control group. While this difference wasn’t statistically significant, it showed a trend towards fewer recurrences in the diet group.

2. Patients with Paroxysmal AFib: For patients who had AFib that comes and goes on its own (paroxysmal AFib), the Mediterranean diet significantly reduced the recurrence of AFib. Only 25.2% of these patients had AFib return, compared to 34.7% in the control group.

4 Possible Reasons How the Mediterranean Diet May Help AFib

While the exact reasons are still being studied, here are some possible ways the Mediterranean diet might benefit AFib patients:

1. Anti-Inflammatory Properties: The diet is rich in anti-inflammatory foods like fruits, vegetables, and fish. Inflammation is a known factor in AFib, so reducing inflammation could help prevent it.

2. Heart Health: Foods like olive oil and fish contain healthy fats that improve heart health, possibly making the heart less prone to AFib.

3. Weight Management: There is a clear link between being overweight and atrial fibrillation (AFib). The Mediterranean Diet can help maintain a healthy weight, which reduces the strain on the heart and decreases the risk of AFib. However, it’s important to note that the Mediterranean Diet didn’t lead to any weight loss in this study. To achieve weight loss with the Mediterranean Diet, you should focus on cutting calories by cutting out the empty calories of alcohol, replacing whole grains with more vegetables, and substituting legumes, like garbanzo beans, for meat and dairy.

4. Blood Pressure: While the Mediterranean diet has been shown to help lower blood pressure, which is a major risk factor for AFib, no blood pressure reduction was seen in this study. Once again, if they had designed the study to also result in weight loss, they would have seen a significant drop in blood pressure.

Dr. Day’s Take on this Mediterranean Diet Study to Treat AFib

Dr. Maria T. Barrio-Lopez and her colleagues from Spain deserve recognition for successfully conducting a multicenter randomized dietary study on AFib. Getting 720 people to follow a specific diet for 18 months is a significant accomplishment!

The primary goal of their study was to reduce AFib progression in all patients. Unfortunately, this goal was not fully met. Here is a published report of what this study was designed to accomplish before they enrolled their first patient.

While there was a trend suggesting that the Mediterranean Diet might benefit all AFib ablation patients, it didn’t reach statistical significance. However, the study did find that patients with the less severe form of AFib, known as paroxysmal AFib, appeared to benefit from the Mediterranean Diet. Specifically, these patients experienced a 31% reduced risk of their AFib returning.

I believe the benefits of the Mediterranean Diet for preventing AFib recurrence after an ablation could have been greater if alcohol consumption had been limited, as alcohol is a major trigger for AFib, and if the diet had been adjusted to promote weight loss. In my experience, many of my overweight patients have been able to put their AFib into remission through significant weight loss with the Mediterranean Diet by replacing grains with vegetables and substituting much of their meat and dairy with natural plant-based proteins like legumes.

Conclusion

The Mediterranean diet, enriched with extra-virgin olive oil, shows promise in reducing the recurrence of AFib after an ablation procedure, especially for those with paroxysmal AFib. Incorporating this diet into your lifestyle could be a beneficial step towards maintaining a healthy heart and preventing AFib from coming back if you are already at a healthy weight. For those who are overweight, our research has consistently shown that losing weight after an ablation helps to keep AFib from ever coming back. Always consult with your doctor or a nutritionist before making significant changes to your diet.

Disclaimer

The information provided in this blog article is for educational purposes only and is not intended to replace professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or dietary changes. Do not disregard professional medical advice or delay in seeking it because of something you have read in this article. Individual results may vary, and it is important to consult with your healthcare provider before starting any new diet or health program.

About the Photo

This photo was taken during one of my recent evening mountain bike rides after work. I love riding the trails above Salt Lake City in the spring and late fall when the mountains are still covered with snow.