Gender differences in adherence to Mediterranean diet and risk of atrial fibrillation

Abstract

Background: Adherence to Mediterranean Diet (MedD) is associated with a reduction of overall mortality and mortality from cardiovascular diseases and cancer. In a previous study we found a relationship between intake of antioxidant vitamins with diet and risk of atrial fibrillation (AF). The present study focused on gender differences among diet and antioxidants intake in patients (pts) with a first detected episode of AF. Methods: A group of 400 pts, 205 men and 195 women was investigated. A control group of 400 subjects, age and sex matched, was selected and compared. Nutritional parameters were assessed by a self-administered food frequency validated questionnaire (116 items) completed by an interviewer-administered 24 h diet recall. We have previously constructed a MedD adherence score based on a prior scoring system developed for Greek populations. Consumption of cereals, vegetables, legumes, fruit, fish, dairy products, number of cup of espresso coffee, chocolate snacks and soda drink, wine was investigated. Results: In the total population the MedD Score was higher in control pts compared to AF (27.9±5.6 vs 22.3±3.1; p<0.001) and gender analysis showed that MedD Score was higher in women compared to men (28.8±2.0 vs 20.1±2.5; p<0.001). In the group of patients with AF the MedD Score was higher in women compared to men (24.3±2.0 vs 19.1±2.2; p<0.001). Comparing women with AF and women without AF the MedD Score was lower in AF group (24.3±2.0 vs 27.9±5.6; p<0.001). Similarly, men with AF had a lower adherence to MedD Score (19.1±2.2 vs 21.4±2.5; p<0.001). In pts with AF the estimated intake of total antioxidants was higher in women compared to men (19.9±5.6 vs 11.2±7.4 mmol/d; p<0.001). Women from control group had a higher estimated intake of total antioxidants compared to women with AF (22.3±7.1 vs 19.9±5.6 mmol/d; p<0.05). The analysis of sources of antioxidants showed that women with AF had a higher intake from vegetables and fruits, on contrary men with AF had a higher intake from cereals and coffee. Women were more likely to be tea consumers compared with men. Low level of antioxidants intake was also associated with an increasing risk of developing AF (O.R. 1.9; 95% CI 1.65-3.2; P<0.01). Conclusions: Women showed high adherence to MedD and higher intake of antioxidant form fruit and vegetables compared to AF men. Men had higher intake of antioxidants from coffee. Women that developed AF were older, with lower adherence to MedD, and more sedentary