Algorithm for personalization of diet therapy in patients with atrial fibrillation and obesity based on metabolic status assessment

Abstract

Aim: To develop an algorithm for personalizing the diet therapy of patients with obesity and atrial fibrillation (AF) based on the assessment of the metabolic status.Material and Methods. The study included 100 patients with grade III obesity and paroxysmal AF. All subjects had nonvalvular AF. Anthropometric parameters, actual nutrition, bioimedance analysis of body composition, basal metabolic rate (BMR) were assessed.Results. Changes in basal metabolism by gender were identified. In women – a decrease in the rate of carboydrate oxidation (CHO) (by 27 ± 12.2%, p < 0.05), an increase in fat oxidation (by 48,58 ± 14.6%, p < 0.01). In men – a decrease in BMR (by 26,23 ± 13.6%, p < 0.05), CHO (by 57,18 ± 18.1%, p < 0.01) and protein (by 28,06 ± 12.9%, p < 0.05), increased rate of fat oxidation (by 31,42 ± 10.0%, p <0.05). A hyperphagic pattern of actual nutrition has been established: excess daily energy intensity (by 16–44%), excess of daily intake of proteins (by 34–54%), fats (by 17% in women) and carbohydrates (by 57–72%, p < 0.05). An excessive amount of saturated fat, cholesterol, and added sugar was revealed in the diet. A deficiency in vitamin D intake was found (by 8–16%, p < 0.05). The maximum daily energy requirement for 95% of women is within 2250 kcal/day, for men – 2950 kcal/day.Conclusion. Metabolic status disorders serve as factors of hemodynamic overload, humoral and electrical dysfunction of the heart. Diet therapy is a powerful component in the treatment and prevention of AF. It is advisable to carry out an algorithm for individual correction of the chemical composition and energy value of diet therapy taking into account the optimal metabolic corridor of needs, enriching the diet with vitamin D, eliminating added sugar, cholesterol, sodium, phosphorus, and sources of vitamin K.