Abstract
Background: Although recent large randomized clinical trials showed an increased risk of atrial fibrillation (AF) with marine omega-3 fatty acids supplements, it is unclear whether dietary marine omega-3 fatty acids assessed through food frequency questionnaires are associated with AF risk. Hence, we sought to test the hypothesis that dietary eicosapentaenoic acid/docosahexaenoic acid/docosapentaecnoic acid (EPA/DHA/DPA) is associated with a higher risk of AF in a large prospective cohort of US Veterans. Methods: We analyzed data from Million Veteran Program participants who completed self-reported food frequency questionnaires. We used multivariable Cox regression to estimate hazard ratios of AF across quintiles of omega-3 fatty acids consumption and a cubic spline analysis to assess the dose-response relationship between omega-3 fatty acids and AF. Results: Of the 301,294 Veterans studied, the mean intake of omega-3 fatty acids (EPA/DHA/DPA) was 0.39 g/day (SD 0.38), the mean age was 64.9 (SD 12.0) years; 91.2% (274,881 of 301,294) male and 84.0% (253,144 of 301,294) White. Consumption of EPA/DHA/DPA exhibited a non-linear inverse relation with incident AF characterized by an initial decline to 11% at 0.75 g/day of marine omega-3 fatty acids intake followed by a plateau. Conclusions: Contrary to our hypothesis, dietary EPA/DHA/DPA was not associated with a higher risk of AF but was inversely related to AF risk in a non-linear manner.
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