title: A U-shaped association between consumption of marine n-3 fatty acids and development of atrial fibrillation/atrial flutter-a Danish cohort study.
abstract: OBJECTIVE
  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.
  
  
  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.
  
  
  CONCLUSIONS
  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).
authors.affiliation: 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.
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Rix
authors.affiliation: Department of Cardiology, Aalborg AF Study Group, Center for Cardiovascular Research, Aalborg University Hospital, 9100 Aalborg, Denmark.
authors.forename: Albert M
authors.initials: AM
authors.lastname: Joensen
authors.affiliation: 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.
authors.forename: Sam
authors.initials: S
authors.lastname: Riahi
authors.affiliation: Department of Cardiology, Aalborg AF Study Group, Center for Cardiovascular Research, Aalborg University Hospital, 9100 Aalborg, Denmark.
authors.forename: Søren
authors.initials: S
authors.lastname: Lundbye-Christensen
authors.affiliation: Danish Cancer Society Research Center, 2100 Copenhagen, Denmark.
authors.forename: Anne
authors.initials: A
authors.lastname: Tjønneland
authors.affiliation: Department of Cardiology, Aalborg AF Study Group, Center for Cardiovascular Research, Aalborg University Hospital, 9100 Aalborg, Denmark.
authors.forename: Erik B
authors.initials: EB
authors.lastname: Schmidt
authors.affiliation: 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.
authors.forename: Kim
authors.initials: K
authors.lastname: Overvad
mesh_terms: D000818:Animals; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D001282:Atrial Flutter / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D003718:Denmark / Q000453:epidemiology; D004032:Diet; D004281:Docosahexaenoic Acids / Q000008:administration & dosage; D015118:Eicosapentaenoic Acid / Q000008:administration & dosage; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage*; D005231:Fatty Acids, Unsaturated / Q000008:administration & dosage; D005260:Female; D005399:Fishes; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017711:Nonlinear Dynamics; D016016:Proportional Hazards Models; D065840:Protective Factors; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D040242:Risk Reduction Behavior; D017747:Seafood; D011795:Surveys and Questionnaires
chemical_list: D015525:Fatty Acids, Omega-3; D005231:Fatty Acids, Unsaturated; D004281:Docosahexaenoic Acids; D015118:Eicosapentaenoic Acid; C026219:docosapentaenoic acid
keywords: Atrial fibrillation; Diet; Fish; n-3 Polyunsaturated fatty acids