Unlock Heart Health: How the Mediterranean Diet Fights Atrial Fibrillation Naturally!

If you're looking for a heart-healthy eating plan, the Mediterranean diet might be right for you. The Mediterranean diet is a way of eating based on the traditional cuisine of countries bordering the Mediterranean Sea. There's no single definition for the diet. The foundation of the Mediterranean diet is plant foods. Moderate amounts of dairy, poultry and eggs are part of the Mediterranean diet, as is seafood. Unsaturated fats are a strength of the Mediterranean diet. Olive oil and nuts are the main sources of fat in the Mediterranean diet. They provide unsaturated fat. Fish also are a key part of the Mediterranean diet. A 2024 article suggests plant-based diets and the Mediterranean diet contain components that research links to a lower risk of AFib, including fruits, whole grains, and healthy fats.

Understanding Atrial Fibrillation (AFib)

Atrial fibrillation (AFib) is a type of arrhythmia that affects the upper chambers of the heart. The electrical impulses that control these chambers fire in a disorganized way, leading to an irregular heartbeat. AFib itself is not a life threatening condition. However, it can increase the risk of stroke, blood clots, and congestive heart failure. A suitable diet may also decrease the risk of developing other heart conditions alongside AFib. AF is the most common sustained cardiac arrhythmia. Strategies for improving results for AF ablation have focused on technology and pharmacology but have not extensively looked at lifestyle and diet.

The Core Principles of the Mediterranean Diet

The Mediterranean diet is a healthy-eating plan. Diet is known to have an effect on long-term diseases. These include heart and blood vessel problems known as cardiovascular disease. Today, the Mediterranean diet is one of the healthy eating plans that American nutrition experts recommend. And other diets have some of the same recommendations as the Mediterranean diet.

The traditional Mediterranean diet is characterized by a low content of saturated fatty acids (SFAs) and high levels of monounsaturated fatty acids (MUFAs), carbohydrates, and fiber, derived predominantly from vegetables, fruits, grains, and notably, olive oil. The diet is rich in essential nutrients such as beta-carotene, vitamins C and E, folate, flavonoids, polyphenols, as well as various essential minerals and trace elements, all of which have demonstrated benefits for human health, particularly in the context of cardiovascular diseases.

Emphasis on Plant-Based Foods: Each day, aim for 2 to 3 servings of fruit and four or more servings of vegetables. One serving of fruit equals a medium piece of whole fruit or one cup of chopped. Choose whole grains. Switch to whole-grain bread, cereal and pasta. You also can try other whole grains, such as bulgur, barley and farro. If you eat about 2,000 calories a day, aim to have at least 3 ounces of whole grains. You can get 1 ounce from a slice of bread, a cup of ready-made cereal, or half a cup of cooked rice or pasta.
Healthy Fats: Unsaturated fats are a strength of the Mediterranean diet. Olive oil and nuts are the main sources of fat in the Mediterranean diet. They provide unsaturated fat. Replacing saturated fats with unsaturated fats may help lower the risk of heart disease. For example, you could replace butter with olive, canola, or safflower or sunflower oil in cooking or at the table.
Seafood Consumption: Eat more seafood. Eat fish or shellfish 2 to 3 times a week. Children and people who are pregnant or breastfeeding may want to limit certain types of fish due to mercury levels. One serving of fish is around 3 to 5 ounces for adults. That's about the size of a deck of cards. Fresh or water-packed tuna, salmon, trout, mackerel and herring are healthy choices. Lean fish and shellfish also are included in the Mediterranean diet. Shellfish include shrimp, crab, clams and scallops. Choose fish that are low in mercury, such as the ones listed above. Too much mercury can harm the brain and nervous system over time. These are known as fatty fish. Omega-3s are unsaturated fats that may lower immune system action in the body known as inflammation. They also may help reduce blood fats called triglycerides, and they affect blood clotting.
Dairy in Moderation: Some good choices are skim or 1% milk, low-fat cottage cheese, and low-fat Greek or plain yogurt. Limit how much cheese you eat. One serving is about the size of four dice. And cut back on higher fat dairy.
Lean Protein: Reduce red and processed meat. Eat more fish, poultry or beans instead. If you eat meat, make sure it's lean and keep portions small.
Flavor Enhancement: Spice it up. The Mediterranean diet has a lot of flexibility, so you can make it a delicious and nutritious way to eat.

Potential Benefits for AFib Management

Although diets like the Mediterranean diet may have a positive effect on AFib, people should speak with a healthcare professional, such as a registered dietitian, before changing their diet to manage this condition.

Improving heart health: A 2019 study found that people who follow the Mediterranean diet have better overall heart health then those who do not.Platelet function: A 2021 randomized control trial suggests the Mediterranean diet maintains platelet count and may reduce platelet-related mortality in older adults at high risk of heart conditions.Lower blood pressure: The Mediterranean diet may help to lower blood pressure, particularly in people with overweight or obesity who have untreated hypertension. High blood pressure is a risk factor for AFib.Reduced risk of stroke: The Mediterranean diet may reduce the risk of someone having a stroke. Since AFib is the leading cardiac cause of stroke, this may benefit people with AFib.

Foods to Limit or Avoid

Foods to avoid may include those that directly trigger symptoms and raise the risk of AFib complications. Foods and drinks to avoid may include:

Caffeine and Energy Drinks: The AHA recommends that people avoid excessive amounts of caffeine to lower their risk of AFib. However, a 2019 study found that drinking 1-3 cups of coffee daily may reduce AFib risk in males.If a person believes that caffeine could be a personal trigger, they may wish to avoid caffeinated foods and drinks, such as coffee and tea.People with AFib can also speak with their doctor about the benefits and risks of reducing their caffeine intake.
Alcohol: The AHA also warns against drinking excessive amounts of alcohol with AFib.A 2022 meta-analysis suggests alcohol may be a trigger for AFib. The authors suggest that any amount of alcohol may increase the risk of AFib in men, and over 1.4 drinks daily may increase the risk for women.However, the authors highlight the need for further research into the cause of this gender difference, including whether alcohol type or frequency of consumption has an effect.
Red Meat: Red meats such as beef or lamb tend to have higher amounts of saturated fat than white meat. The AHA recommends people with AFib consume a diet low in saturated fats.
Processed Foods: Processed foods, such as ready meals, carbonated soft drinks, or hot dogs, tend to have large quantities of salt and preservatives. It may be best to limit the intake of these as they can adversely affect the heart. A 2023 research article examined medical data from 121,300 people in the United Kingdom. The authors associated diets containing ultra-processed food with an increased risk of AFib.
Sugary Foods and Drinks: The British Heart Foundation recommends that people choose sugar-free snacks and swap snacks with added sugar with alternatives, such as:fruit, Greek yogurtnut butter, cashew nutsalmonds. Controlling blood sugar levels is particularly important for people with diabetes since diabetes is a risk factor for AFib.
Salt: Someone may have more frequent AFib episodes if they consume food with large quantities of salt. Reducing salt intake may be a useful way to help reduce AFib.

Lifestyle Adjustments for Heart Health

There are several other ways a person with AFib can adjust their lifestyle to promote heart health.

Quit Smoking: According to a 2018 article, people who smoke may be 2.1 times more likely to develop AFib. Quitting smoking or not starting smoking at all may significantly improve a person’s risk of getting AFib.
Manage Sleep Conditions: A 2019 systematic review concluded that getting less than six hours of sleep a night or over eight hours a night may increase the risk of AFib.The management of sleep apnea and stress may help a person improve the quality of their sleep.
Improve Relaxation: Stress and anxiety have a significant effect on AFib. A 2023 literature review suggests that stress or anxiety and AFib may have a bidirectional relationship, in which both can trigger the other. The authors suggest that stress biomarkers, such as elevated cortisol levels, may play a role in AFib development. However, further research is necessary. Regular relaxation and stress reduction through activities like yoga may help someone manage these emotions.

Research Evidence and Studies

PREDIMAR Trial: In the trial, researchers randomized 720 AF patients treated with ablation in a 1:1 ratio, with one group receiving advice to follow a Mediterranean diet enriched with extra-virgin olive oil or their freely selected diet. The trial followed all patients for 18 months with medical visits every 3 to 6 months. After 18 months, the results showed a 10% relative reduction in the risk of tachyarrhythmia recurrence in patients following the Mediterranean diet enriched with extra-virgin olive oil compared to patients who freely selected their diet. This reduction was even higher in patients with paroxysmal AF at baseline (before ablation).
AFHRI Study: In multivariable adjusted binary logistic regression analyses, we found inverse associations between both dietary indices (MEDAS: Median = 3, HEI: Median = 54.9) and the presence of AF (odds ratio for MEDAS: 0.65, 95% confidence interval (CI): 0.47-0.91, odds ratio for HEI: 0.60, 95% CI 0.39-0.95). Based on randomised controlled trials, a Mediterranean diet is recommended in European and international guidelines as a “healthy heart” diet.

Read also: Delicious Mediterranean Recipes
Beijing Anzhen Hospital Study: This study demonstrates that adhering to a Mediterranean diet is inversely associated with the risk of AF. Even after controlling for known influencing factors, this correlation persists. Particularly, individuals scoring 6-9 on the AMED scale exhibit a significantly lower risk of AF compared to those scoring 0-3.

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