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Storz MA, Helle P. Atrial fibrillation risk factor management with a plant-based diet: A review. J Arrhythm 2019; 35:781-788. [PMID: 31844466 PMCID: PMC6898539 DOI: 10.1002/joa3.12254] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 09/19/2019] [Accepted: 10/13/2019] [Indexed: 12/13/2022] Open
Abstract
Atrial fibrillation is the most prevalent cardiac arrhythmia in the clinical setting affecting approximately 34 million individuals worldwide. The disease is associated with a significant burden of morbidity and mortality resulting from stroke, heart failure, and acute coronary syndrome. Atrial fibrillation is now a major public health problem with tremendous implications on the economy and the world's healthcare systems. Numerous risk factors and clinical conditions that are associated with the development and progression of atrial fibrillation have been identified in the past. Within the last decades, a shift in awareness toward modifiable conditions has been observed and risk factor management has gained significant momentum. In light of this, dietary approaches are of paramount importance. Whole-food plant-based diets emphasizing grains, legumes, vegetables, fruits and nuts and excluding most (or all) animal products have recently experienced a significantly increased interest. The purpose of this review is to present evidence suggestive of a plant-based diet being a valuable tool in atrial fibrillation risk factor management. The effects of a plant-based diet on both established and emerging risk factors, such as inflammation and subclinical atherosclerosis, are reviewed in this article. A special focus is put on cardiovascular and metabolic risk factors including hypertension, coronary artery disease, diabetes, and obesity.
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Affiliation(s)
| | - Paul Helle
- Department of Intensive Care MedicineDie FilderklinikFilderstadt‐BonlandenGermany
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Cainzos-Achirica M, Bilal U, Al Rifai M, McEvoy JW, Blumenthal RS, Kapoor K, Martinez-Sanchez JM, Comin-Colet J, Pladevall-Vila M, Blaha MJ. Communication issues in nutritional observational research. Prev Med 2018; 115:76-82. [PMID: 30145349 DOI: 10.1016/j.ypmed.2018.08.024] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 08/13/2018] [Accepted: 08/21/2018] [Indexed: 12/12/2022]
Abstract
Observational epidemiological studies involving foods and nutrients often attract great attention from both the press and the public as they involve substances that are part of the daily lives of millions of individuals. In the digital era, findings of this research can be disseminated to very large audiences almost instantaneously, informing health beliefs and potentially triggering lifestyle changes. In this context, communication of results from observational nutritional epidemiology often involves specific issues that may limit the accuracy of the information ultimately being delivered to the public. In this narrative review we discuss some of these issues, with a special attention to the selective reporting of research studies by the media, the presentation of study findings as if they were free of bias, the reporting of inconsistent study results, and the issues related to the real-life uptake of research findings presented in the press. Collaborative efforts by all stakeholders involved in the dissemination process may help ameliorate this situation, and with this purpose we discuss some innovative approaches that may help reduce these issues.
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Affiliation(s)
- Miguel Cainzos-Achirica
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins Medical Institutions, Baltimore, MD, USA; Bellvitge University Hospital and Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; RTI Health Solutions, Pharmacoepidemiology and Risk Management, Barcelona, Spain
| | - Usama Bilal
- Urban Health Collaborative, Drexel Dornsife School of Public Health, Philadelphia, PA, USA; Social and Cardiovascular Epidemiology Research Group, School of Medicine, University of Alcala, Alcala de Henares, Madrid, Spain
| | - Mahmoud Al Rifai
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - John W McEvoy
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins Medical Institutions, Baltimore, MD, USA; Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Roger S Blumenthal
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Karan Kapoor
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | | | - Josep Comin-Colet
- Bellvitge University Hospital and Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, University of Barcelona, Barcelona, Spain
| | - Manel Pladevall-Vila
- RTI Health Solutions, Pharmacoepidemiology and Risk Management, Barcelona, Spain; The Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, MI, USA
| | - Michael J Blaha
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins Medical Institutions, Baltimore, MD, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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Affiliation(s)
- Dag S Thelle
- 1 Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Norway.,2 Department of Public Health and Community Medicine, Gothenburg University, Sweden.,3 Department of Chronic Diseases, Norwegian Institute of Public Health, Oslo, Norway
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Czick ME, Shapter CL, Silverman DI. Atrial Fibrillation: The Science behind Its Defiance. Aging Dis 2016; 7:635-656. [PMID: 27699086 PMCID: PMC5036958 DOI: 10.14336/ad.2016.0211] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Accepted: 02/11/2016] [Indexed: 12/19/2022] Open
Abstract
Atrial fibrillation (AF) is the most prevalent arrhythmia in the world, due both to its tenacious treatment resistance, and to the tremendous number of risk factors that set the stage for the atria to fibrillate. Cardiopulmonary, behavioral, and psychological risk factors generate electrical and structural alterations of the atria that promote reentry and wavebreak. These culminate in fibrillation once atrial ectopic beats set the arrhythmia process in motion. There is growing evidence that chronic stress can physically alter the emotion centers of the limbic system, changing their input to the hypothalamic-limbic-autonomic network that regulates autonomic outflow. This leads to imbalance of the parasympathetic and sympathetic nervous systems, most often in favor of sympathetic overactivation. Autonomic imbalance acts as a driving force behind the atrial ectopy and reentry that promote AF. Careful study of AF pathophysiology can illuminate the means that enable AF to elude both pharmacological control and surgical cure, by revealing ways in which antiarrhythmic drugs and surgical and ablation procedures may paradoxically promote fibrillation. Understanding AF pathophysiology can also help clarify the mechanisms by which emerging modalities aiming to correct autonomic imbalance, such as renal sympathetic denervation, may offer potential to better control this arrhythmia. Finally, growing evidence supports lifestyle modification approaches as adjuncts to improve AF control.
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Affiliation(s)
| | | | - David I. Silverman
- Echocardiography Laboratory, Hartford Hospital, Hartford, CT 06106, USA.
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Alsunni A, Majeed F, Yar T, AlRahim A, Alhawaj AF, Alzaki M. Effects of energy drink consumption on corrected QT interval and heart rate variability in young obese Saudi male university students. Ann Saudi Med 2015; 35:282-7. [PMID: 26497707 PMCID: PMC6074217 DOI: 10.5144/0256-4947.2015.282] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Consumption of energy drinks has adverse effects on the heart that might be potentiated in obese individuals. Since the incidence of obesity and use of energy drinks is high among Saudi youth, we used non-invasive tests to study hemodynamic changes produced by altered autonomic cardiac activ.ity following consumption of energy drinks in obese male students. DESIGN AND SETTING This cross-sectional study was carried out at Department of Physiology, College of Medicine, University of Dammam, Saudi Arabia, over a one-year period from December 2013 to December 2014. SUBJECTS AND METHODS In Saudi male university students we measured continuous ECG recordings and a one-minute deep breathing maneuver to measure the expiratory-to-inspiratory ratio, the mean heart rate range (MHRR), the mean percentage variability. (M%VHR) and the corrected QT interval (QTc) at 0, 30 and 60 minutes after consumption of energy drink. RESULTS We enrolled 31 students (18 overweight/obese and 13 normal weights. QTc was significantly in.creased at 60 min as compared with the resting state in overweight/obese subjects (P=.006). Heart rate variability was significantly less in obese as compared with normal weight subjects at 60 minutes as indicated by E:I ratio, (P=.037), MHRR (P=.012), M%VHR (P=.040) after energy drink consumption. Significant increases in diastolic (P=.020) and mean arterial blood pressure (P=.024) were observed at 30 minutes in the obese group. CONCLUSION Hemodynamic changes after intake of energy drinks in obese subjects indicate that obesity and energy drinks could synergistically induce harmful effects. This finding warrants efforts to caution the obese on intake of energy drinks and timely intervention to motivate changes in lifestyle.
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Affiliation(s)
| | - Farrukh Majeed
- Farrukh Majeed MD, Department of Physiology,, University of Dammam,, Al-Rakha, Al Khobar 31441,, Saudi Arabia, fmajeed@ uod.edu.sa
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