The following are key points to remember from a systematic review on diet and risk of atrial fibrillation (AF):

1. AF is a highly common cardiac arrhythmia. Diabetes, obesity, and hypertension are risk factors for AF, which may be partially modified through dietary interventions. There are no randomized controlled trials (RCTs) investigating the effects of dietary patterns on new-onset, postoperative, or recurrent AF.
2. No definitive evidence from prospective cohort studies currently backs any particular diet for lowering the risk of new-onset AF, including the Mediterranean diet, which may only show potential benefits when supplemented with extra virgin olive oil. Diets high in ultra-processed foods may increase new-onset AF risk.
3. Alcohol intake is associated with increased risk for AF (new-onset and recurrent) in a dose-dependent relationship. Differences in this relationship have been observed between men and women. There are no prospective cohort studies investigating the effects of alcohol on postoperative AF.
4. RCTs have shown that long-term, high-dose n-3 polyunsaturated fatty acid (PUFA) supplementation increases the risk of new-onset AF and that short-term n-3 PUFA supplementation decreases the risk of postoperative AF; differences in study design and intervention components may in part explain this. Data on the relationship between saturated and monounsaturated fatty acids and new-onset AF are also limited.
5. Findings from several small RCTs suggest that perioperative oral vitamin C supplementation, combined with other therapies, may lower the incidence of postoperative AF. However, insufficient data from prospective cohort studies and RCTs exist to confirm whether vitamin C can reduce the risk of new-onset or recurrent AF. Current studies that examine caffeine/coffee, chocolate, fish consumption, and magnesium show no clear association with AF risk.
6. Data on possible associations between salt intake and the risk of AF are inconclusive. Similarly, data on magnesium supplementation and AF are limited.
7. High-quality data from RCTs are rarely available, and the results of most meta-analyses of partially low-quality observational studies are often inconclusive. Further evidence is required to allow clear recommendations concerning diet in patients with AF in future guidelines.

Clinical Topics: Arrhythmias and Clinical EP, Prevention, Atrial Fibrillation/Supraventricular Arrhythmias, Diet

Keywords: Atrial Fibrillation, Diet

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